[Multisegmental posterior cervical fusion with en bloc laminectomy--surgical technique]

In patients with cervical spinal stenosis, the posterior laminectomy represents a surgical alternative to anterior procedures. Whereas the majority of surgeons prefer anterior procedures to treat mono- to three-segmental pathologies, posterior procedures have several advantages if the pathology includes four or more segments.

In general, the indications for a posterior laminectomy resemble those for anterior procedures. Specifically patients with multisegmental pathologies benefit from a shorter operative time as well as reduced perioperative morbidity.

A midline incision is made and followed by subperiostal exposure of the cervical spine. Facet decortication and screw hole preparation can be performed if a fusion is required. The lamina is now separated from the lateral mass using a high-speed burr and elevated en bloc from the dura. The fusion can now be completed.

The posterior en bloc laminectomy with or without fusion represents a viable alternative to anterior procedures in patients with a cervical spinal canal stenosis. It often is the technique of choice for treating more than 3 levels.