Posterior Cervical Laminectomy, Foraminotomy & Fusion
Some cervical problems are best reached from the back of the neck. A minimally invasive posterior foraminotomy relieves a pinched nerve through a tube without any fusion or implant, preserving full motion. For multilevel spinal cord compression, a laminectomy removes the roof of the spinal canal to give the cord room, and instrumented fusion stabilizes the neck when needed. Navigation guides screw placement for accuracy.
Who it is for
- Foraminotomy: single-level radiculopathy from a soft lateral disc or foraminal spur
- Laminectomy and fusion: multilevel cervical myelopathy, especially with compression from behind
- Instability or kyphosis after previous surgery
- Cervical fractures or tumors requiring stabilization
Why we use it
- Foraminotomy preserves motion with no implant
- Effective decompression for multilevel disease
- Navigation improves accuracy and safety
- Avoids swallowing-related recovery of anterior surgery
How the procedure is done
- General anesthesia; positioned face-down with the head secured.
- Foraminotomy: a 1.5 cm incision and tubular retractor; a small keyhole of bone is removed to free the nerve.
- Laminectomy/fusion: a midline incision; the lamina is removed to decompress the cord.
- Screws are placed into the lateral masses or pedicles under navigation and connected with rods; bone graft is applied.
- Layered closure; a drain is often used overnight.
Recovery
Foraminotomy: home the same day, desk work within a week. Fusion: 1–3 nights in hospital, a collar for several weeks in some cases, lifting restrictions for six weeks, fusion healing over 3–6 months. Neck muscle soreness is more prominent than after anterior surgery.
Risks, stated plainly
Infection, spinal fluid leak, nerve root irritation (C5 palsy after multilevel decompression, usually temporary), non-union, hardware problems, neck stiffness. Dr. Daggubati reviews the specific risks for your situation in person before any decision is made.
Preparing for this surgery
Dr. Daggubati has written detailed guides for this procedure covering medications to stop, prehabilitation, the day of surgery, and a week-by-week recovery timeline.