Cervical laminectomy: technique

Spinal canal decompression via cervical laminectomy with or without foraminotomy is a mainstay of treatment of cervical spondylotic myelopathy and myeloradiculopathy. The goal of this surgery is to expand the cervical canal dorsally by removing the spinous processes, laminae, ligamentum flavum, and bony hypertrophy that are contributing to the canal stenosis. In selecting this particular approach to decompression, the surgeon must take into account the spinal geometry and the primary pathology of the patient: an "effective" cervical kyphosis is a contraindication to a dorsal approach, and spinal canal compromise secondary to ventral compression is best addressed through a ventral or a combined ventral and dorsal approach. This technique is technically facile and versatile in application. Complications with this procedure are relatively rare, with postoperative spinal instability being the primary concern. With proper patient selection and attention to surgical technique, laminectomy is a safe and effective approach to the management of cervical myelopathy in selected patients.