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Posterior Decompression

What is Posterior Cervical Decompression?

Posterior cervical decompression is a surgical procedure performed through the back of the neck to relieve pressure over compressed nerves in the cervical spine region caused by inflamed spinal tissue or nerves, by removing portions of the cervical vertebrae. Injury or wear-and-tear can cause parts of the cervical vertebrae to compress the nerves of the spinal cord, leading to pain, numbness, or tingling in the part of the body that the nerve supplies.

Posterior cervical decompression can be performed through a minimal invasive approach. It does not require cutting and stripping of the muscles from the spine region, unlike the conventional open spine surgery, which requires spine muscles to be cut or stripped.

Cervical Spine Anatomy

The spine is made up of 33 small bones called vertebrae and is known as the spinal column or vertebral column. It can be divided into 5 parts: cervical, thoracic, lumbar, sacral, and coccyx region. The cervical spine is comprised of the first 7 vertebrae (C1-C7) and supports the neck and the head. The vertebrae are protected by spongy vertebral disks present between them and is supported by ligaments that hold them together and surround the underlying spinal cord.

Indications for Posterior Cervical Decompression

Posterior cervical decompression is usually indicated for herniated disks, spinal stenosis, bone spurs, bulging disks, spinal injury, spinal tumours and when conservative treatment options do not provide relief.

Preparation for Posterior Cervical Decompression

You will have a preoperative assessment session before surgery. During your assessment, you must inform your doctor about any health conditions you may have, such as diabetes or bleeding disorders, and about any medications that you may be taking, such as blood thinners and over-the-counter medications. You may be asked to stop taking certain medicines for several days before the procedure.

Your doctor will explain the surgical procedure, its risks and benefits, and answer all your other surgery-related queries before the procedure. Blood tests, X-rays or other imaging tests may also be ordered to assess your medical condition.

Procedure for Posterior Cervical Decompression

The procedure is performed in the back of the neck under anaesthesia with you lying face down.  Your surgeon makes a small incision in the midline over your cervical spine region. The layers of neck muscles are separated using a retractor, and the affected nerve root is identified. The lamina (bony arch of your vertebra) may be removed (laminectomy) and the facet joints may be trimmed to reach the compressed nerve. Then, the bone or disk material and/or thickened ligaments are removed, relieving the pressure on spinal nerve structures, creating decompression. The neck muscles are brought back into their original position by removing the retractor. The incisions are closed with absorbable sutures and covered with a dressing.

Postoperative Care Instructions

You can expect your post surgery hospitalization to last up to 7 days. Full recovery from cervical decompression surgery can take an average of 5 weeks. You will be discharged with instructions that need to be diligently followed for a complete recovery, including:

  • You will be prescribed pain medications to keep you comfortable
  • You may be given a soft cervical collar to wear for comfort and pain relief for a couple of weeks
  • Incision site care instructions will be provided to keep the incision clean and dry
  • You may take a shower after 1 week if the incision is closed and well healed and not draining any fluid
  • You need to call your doctor if you notice any swelling, redness, drainage, or increased pain at the incision site
  • You will be instructed on sleeping posture, such as keeping the head of the bed elevated at 30 degrees with the use of pillows or by sleeping in a reclining chair
  • You will need to avoid driving for couple of weeks due to lack of head movement
  • Walking activities are strongly encouraged to aid in recovery
  • No overhead activities or strenuous activities and no lifting more than 15 pounds to avoid strain on the healing vertebrae for the first 1 to 2 weeks
  • Follow-up appointments will be scheduled to monitor progress

Risks and Complications of Posterior Cervical Decompression

As with any surgical procedure, posterior cervical decompression involves potential risks and complications that may include:

  • Infection
  • Bleeding
  • Leakage of cerebrospinal fluid (CSF)
  • Spinal cord or nerve root injury
  • Blood clot in the lungs or legs
  • Spinal instability
  • Neck or arm pain
  • Further procedure