http://www.medilaw.tv Cervical Spine Lateral Mass Screw Fusion Fixation courtroom 3D animations. A laminectomy is a procedure that removes some lamina and spinal processes at the back of the spinal canal to increase the space for, and decrease the pressure on, the spinal cord.
In degenerative spinal stenosis, any of a posterior disc protrusion, bone spurs or osteophytes from the vertebral bodies and facet joints, or buckling or calcification of the spinal ligaments, can compress the spinal cord. In addition, some people are born with a narrow spinal canal, and they tend to get degenerative spinal stenosis symptoms earlier in life, in their forties and fifties. Cervical Spine Lateral Mass Screw Fusion Fixation courtroom 3D animations.
The pressure on the spinal cord can damage it, a process called myelopathy. This can cause pain, weakness, tingling or numbness in the arms or legs, and can affect the use of your hands, how you walk, and your bowel and bladder function. Advanced myelopathy can confine you to a wheelchair. A laminectomy increases the size of the spinal canal, removing the pressure on the spinal cord and usually reduces the progression of the symptoms. Sometimes a fusion of the adjacent vertebrae is also performed to stabilize the region of the laminectomy. The thick neck muscles cover and protect the spinal cord after the bony laminas are removed.
A lateral mass screw fusion is done to realign and stabilize adjacent cervical vertebra. During the procedure, bone graft is placed between the vertebrae. This bone graft will fuse over three months to turn the adjacent vertebrae into one solid bone. While the bone is fusing, it is held still by metal screws and rods.
A potential complication of a laminectomy is a decrease in posterior spine strength and stability leading to misalignment and deformity. A simultaneous lateral mass screw fixation is designed to reduce this risk. Cervical Spine Lateral Mass Screw Fusion Fixation courtroom 3D animations.
INDICATIONS
The indications for a laminectomy with lateral mass screw fixation are persisting pain or weakness, that has been shown by physical examination and radiography to be due to spinal cord compression, and that has not responded to conservative treatment. If there is bowel or bladder dysfunction, difficulty walking, severe muscle weakness, or severe pain that is not controlled by strong pain relievers, your clinician may recommend immediate surgery to prevent permanent spinal cord or nerve damage.
ALTERNATIVES
The non-surgical alternatives to laminectomy may be
- activity modification
- weight loss
- aerobic exercise, such as walking, cycling, and swimming
- strength and flexibility exercises
- physical therapy
- hydrotherapy
- heat and cold pads
- acupuncture
- pain-relieving medications such as acetaminophen or paracetamol, non-steroidal anti-inflammatory drugs, steroid and local anesthetic injections.
However, spinal stenosis is a structural problem, and surgery is the best structural solution.
GOALS
The goals of a laminectomy are to increase the space for the spinal cord to decrease the pressure on the cord, and prevent the myelopathy worsening, while maintaining spinal stability, motion and alignment.
The goal of the cervical lateral mass screw fixation is to stabilize the spine after it has been de-stabilized by the laminectomy. Cervical Spine Lateral Mass Screw Fusion Fixation courtroom 3D animations.
TECHNIQUE
You will be lying on your front. Your neck will be cleaned. An incision will be made in the middle of the neck, and the overlying muscles will be moved to the side. Your surgeon will confirm the position of the correct vertebrae for the procedure by using x-ray imaging. Strips of bone and ligament will be removed from each side of the laminectomy. The lamina and connecting tissues will be removed to decompress the spinal cord. Then the joint surfaces and bone to be fused will be roughened and bone graft will be placed on top. Cervical Spine Lateral Mass Screw Fusion Fixation courtroom 3D animations.
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