Houston Methodist. Leading Medicine

Neck FAQ

Question:

I think I'm ready to take the leap into surgery for my neck. The surgeon wants to cut away the bone around the spinal cord in order to take pressure off the cord. They make a hinge-door and swing it away from the cord without actually removing the whole bone. It sounds too good to be true. What's the downside of this surgery?

Answer:

There are potential complications with any surgery. Infection, bleeding, blood clots, and poor wound healing are the major problems to watch out for. With the particular surgery you are considering, some of the complications may depend on the technique used for the procedure. Surgeons have found various ways over the years to give the spinal cord some added room while stabilizing the vertebrae (spinal bones). For one thing, they found they could cut through the lamina (pillar of bone that forms an arch around the spinal cord) and make a hinge to move the bone away from the spinal cord without removing the bone. It sounds like this is the procedure planned for you. Once the hinge-door has been created, it has to be propped open so it doesn't swing back and shut against the spinal cord again. There are various ways to accomplish this. When this procedure was first developed, the surgeon used stitches but they didn't give the rigid support needed. So they moved on to using bone and ceramic struts or spacers placed between the open edge of the door and the other side of the bone. With this method, there is a risk that the struts will pop out (causing the hinge-door to close) or drop back into the spinal canal. If the strut falls into the spinal canal, pressure on the spinal cord can redevelop. A newer approach is the use of metal plating to expand the space around the spinal cord, provide rigidi support to the bone, and hold the hinge-door open. With this technique, the surgeon doesn't need to use supplemental bone grafting, the costs are less, and the patient can get up and move around right away. Check with your surgeon to find out what types of problems you might face. Besides the surgical technique used, your age and general health are factors. John M. Rhee, MD, et al. Plate-Only Open Door Laminoplasty Maintains Stable Spinal Canal Expansion with High Rates of Hinge Union and No Plate Failures. In Spine. January 2011. Vol. 36. No. 1. Pp. 9-14.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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