Laminectomy and Fusion
The goal of surgery for cervical spondylotic myelopathy (CSM) is to open the space for the spinal cord. This involves removing the parts of bone or soft tissue that are pressing on the cord.
The posterior approach involves an incision along the midline of the back of the neck. Surgery may include laminectomy. This procedure is often accompanied by spinal fusion.
This procedure involves removing the bony arch (lamina), any bone spurs, and ligaments that are compressing the spinal cord. Laminectomy relieves pressure on the spinal cord by providing extra space for it to drift backward.
Laminectomy ensures complete decompression of the spinal cord, but makes the bones less stable. This requires fusion with a bone graft and possibly screws and rods.
Posterior laminectomy is ideal for people with very small spinal canals, enlarged or swollen soft tissues at the back of the spine, and problems in more than four spine segments or levels. These approaches cannot be used in patients with kyphotic (bent forward) spines, since the cord will not shift backwards.