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Causes and Management of Cervical Cord Compression

  • Category: Back Surgery
  • Posted On:
  • Written By: DR. HAMID ABBASI

Cervical cord compression occurs when certain conditions and disorders result in compression of the spinal cord where it runs through the spinal bones of the neck (cervical vertebrae). The causes of cervical cord compression include herniations of the disks between the cervical vertebrae, arthritis of the joints in this area resulting in narrowing of the space where the spinal cord runs through, tumors in the spinal column, or fractures of the cervical vertebrae. If these issues are not managed in time or left to worsen, then patients may become quadriplegics meaning they are paralyzed from the neck down.

Cervical laminoplasty is a surgical procedure that is performed on an affected individual’s neck in order to relieve the pressure being applied by the mentioned pathologies causing compression of the spinal cord. Cervical laminoplasty is performed after the patient is given a general anesthetic and, with the patient lying face down, the surgeon makes an incision through the back of the neck. When the bony area of the neck is reached the surgeon will make partial cuts through both sides of the lamina, the bony plates that form the posterior walls of each vertebra, where the compression of the spinal cord occurs. A complete incision will then be made through one of the partially cut sections of the lamina which is then lifted and a bone, plastic or metallic spacer is placed allowing more space for the spinal cord to maneuver into.

Patients who would benefit from a cervical laminoplasty are those who experience moderate to severe signs and symptoms due to the pathology. These may include numbness or a tingling sensation in the arms and hands, decreased power in the upper limbs, reduced reflexes, and in severe situations no power or reflexes in these areas. Performing a laminoplasty can help allow the patient recover completely with a full reversal of symptoms, or it may just stop the progression of the disease.

Post-surgical outcomes

Cervical laminoplasty is intended to help improve the neurological complaints of the patient, not for pain caused by the compression of the spinal cord in the neck. In fact, pain does increase after the procedure but the affected patient will be able to make full use of their limbs. The pain experienced after the procedure can be managed with the use of oral pain medications and this issue does tend to resolve over time.

The risk of infection and anesthesia-related complications after the procedure is low, but there is about a 50 percent decreased range of motion in the neck. With physical therapy though, this decrease in range of motion of the neck can be reduced with the correct therapies and exercises.

Laminoplasty for cervical spine compression is a safe and effective surgical treatment for the relief of compression of the spinal cord in the neck which can be a severely debilitating and even life-threatening problem if not managed adequately. It is very important to realize that the benefits of the procedure outweigh the risks associated with it.