Cervical laminectomy complications [Neurosurgery Wiki]

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====== Cervical laminectomy complications ======

===== Injury to spinal cord and nerve roots =====

The overall incidence of neurological complications has been reported as 0.18% 
((Currier BL. Neurological complications of cervical spine surgery: C5 palsy and intraoperative monitoring. Spine (Phila Pa 1976). 2012;37(5):E328-E334. doi:10.1097/BRS.0b013e3182417276))
and increases with severe [[cervical kyphosis]] correction (2.6%)
((Hojo Y, Ito M, Abumi K, et al. A late neurological complication following posterior correction surgery of severe cervical kyphosis. Eur Spine J. 2011;20(6):890-898. doi:10.1007/s00586-010-1590-8)).
Late neurological complications can be avoided in posterior corrective surgery for cervical kyphosis by prophylactic foraminotomies in the presence of foraminal stenosis, kyphosis correction that does not exceed 9.7° per spinal segment and avoiding kyphosis correction at C4–C5, which is where the largest posterior shift of the spinal cord occurs leading to[[ C5 palsy]]
((Hojo Y, Ito M, Abumi K, et al. A late neurological complication following posterior correction surgery of severe cervical kyphosis. Eur Spine J. 2011;20(6):890-898. doi:10.1007/s00586-010-1590-8))
((Citation text
Geck MJ, Macagno A, Ponte A, Shufflebarger HL. The Ponte procedure: posterior only treatment of Scheuermann's kyphosis using segmental posterior shortening and pedicle screw instrumentation. J Spinal Disord Tech. 2007;20(8):586-593. doi:10.1097/BSD.0b013e31803d3b16)).
This is a common problem but most cases resolve spontaneously. Similar to anterior surgery, spinal cord monitoring is a good adjunct monitoring tool.
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[[Cervical laminectomy]] may cause postoperative [[cervical kyphotic deformity]] leading to segmental [[instability]] over time. [[Laminoplasty]] may be an alternative procedure to laminectomy, as it protects the spine against post-laminectomy kyphosis; however, similar to laminectomy, laminoplasty may cause [[sagittal plane]] deformities by destructing or weakening the dorsal tension band. 

[[PEEK]] rod-[[cervical lateral mass screw]] systems may be useful in motion preservation surgery of the posterior cervical region
((Aydin AL, Sasani M, Erbulut DU, Oktenoglu T, Ozer AF. A new concept of motion preservation surgery of the cervical spine: PEEK rods for the posterior cervical region [published online ahead of print, 2020 Sep 3]. Biomed Mater Eng. 2020;10.3233/BME-206004. doi:10.3233/BME-206004)).

===== Cervical kyphotic deformity =====

see [[Cervical kyphotic deformity]].

===== Infection =====

Postoperative [[discitis]]....