Posterior Decompression (Laminectomy) with or without Spinal Fusion

Decompression of the spinal cord and nerve roots can also be performed with a posterior approach (laminectomy) of the cervical spine. The choice of the posterior approach is based on several criteria, such as: compression mainly from the back, involvement of multiple levels, older age, and normal cervical lordosis.

During the surgery, a midline posterior incision is made in the neck (over the spinous processes), about 5–10 cm long. The muscles are retracted, the spinous process and the laminae of the vertebrae causing the stenosis are removed, and the spinal cord is decompressed. Afterwards, the corresponding nerves are also decompressed at their foramina.

The procedure may be combined with spinal fusion if there are signs of instability (slippage), severe degeneration, or other reasons.