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Posterior cervical laminectomy/foraminotomy WITHOUT fusion

I apologize if this is getting posted again but in my topics that I've posted it came up empty. I'm on a couple of different boards so sometimes can't remember what's where.

I am having surgery soon - just waiting for insurance approval. I've had a hard time finding anyone who has had a posterior laminectomy/foraminotomy without fusion at C5, 6 and 7 - he will also remove bonespurs. I have come across people who have had one or both, but it seems like it's always with fusion.

My neurosurgeon said it's about a 2 week recovery. I don't think I'd be 100% and from what I've come across it seems like you can drive and be released back to work (with some restrictions) and closer to fully recovered around the 3 months mark.

I understand how the surgery is done for the most part. What I'm really wondering more about is if there is anyone out there who has had this procedure done - what was your recovery like? I am a single parent and I have varying options for help, but it would nice to know what kinds of things I will need help with, how much and for how long. Granted I know that this can vary greatly from person to person but it would just be nice to find SOMEONE who has had this done without fusion!




  • Hi Carmen,

    To answer your question as far as recovery goes, the posterior surgery I will not lie, it does disturb the muscles a lot. You will want to be on a good muscle relaxer following surgery. Now given the type of surgery you are having done the good news is you won't need a collar or anything. If you need to take care of other family members I suggest that you have someone with you for the first week, so you can rest. Getting as much rest as possible will also improve your recovery time. If a week is not doable then at least the first couple of days. I myself had come home by myself following a posterior surgery, and was okay, but I am not sure of the part taking care of others, as it was hard enough just taking care of me.

    As far as the time off, well sometimes that is subject to change pending the surgery and what they actually find. Sometimes not all things are on the MRI's so the surgeons need to do a little extra work. However if you don't have a labor intensive job, then it might very well work. I might suggest that one thing you need to do following your surgery is begin walking. There are several programs on the net, which will help you with your recovery and build your core body strength.

    Good luck on surgery and keep us posted on how you get a long.
  • Thank you so much for your response. I did get the surgery scheduled for July 12th. I am a single mom (and have 3 dogs lol) but my kids are 10 and 13 so can be quite helpful. My parents are going to come for the surgery and hopefully for that first week after to help. The boys' dad actually only lives 2 blocks away and told me that if I needed any help to just let him know. I have a number of friends who have offered rides, errands, meals, etc. so I should have plenty of help if needed. Thankfully I'm a teacher so I won't have to return to work until late August which gives me about 5 weeks after the surgery. And I was told that I would not have to wear a cervical collar although some have said they might give me a soft one to use for short periods of time if my neck feels particularly weak. We'll see - my pre-op appt is on 7/10. Did you have to position yourself in any particular way in order to sleep? Also wondering if there's anything that you wish that you'd known prior to the surgery that you can share! Thanks :)
  • Swedish, I'm on the fence about what to say because I don't want you to worry or have this stress you out. But, I want to be honest. First, my question is why are you having a foraminotomy? Do you have a herniated disc and getting pain? Either way you shoul dknow that all conditions are different and all patients are different. I had a C5 thru C7 foraminotomy 3 years ago. The procedure was painful the first day and had to stay in the hospital an extra night. This whole thing about fusion scared the heck out of me so I went with this procedure instead. They cut through muscle when they do this so its painful but good news is you do recover fast. I was driving within a week. But here's the catch. It doesn't necessarily solve the real problem. In my case I had a herniated disc. This procedure relieved the symptoms but didn't solve them. Well two years later they came back and they had to do a fusion anyway! So I had both surgeries. My neck bothers me all the time where they did the foraminotomies. The fusion surgery isn't painful at all as they don't go through muscle. I don't want to discourage you in any way. The whole reason I'm writing all of this is if your doctor gave you a choice (as mine did) I highly recommend you go with the fusion. If I had to do it all over that is what I would do. My fusion was 3-level. First surgery bill $95,000 and 2nd surgery was $125K. of course i had excellent insurance but going through it twice sucked. So to answer your "also wondering..." comment I seriously wished I had known what I was going to experience. I have muscle atrophy in the surgical area of the foraminotomy and all it did was buy me two years. But all of this depends on YOUR SPECIFIC condition and whether this surgery is right for you. My only motive here is if you are given the choice by your surgeon don't go with the procedure just b/c you don't want a fusion. It's low on the c-spine and you don't lose any motion in your neck by a fusion. Good luck.
  • Bay - the first neurosurgeon wanted to do the 3-level fusion. After talking to the 2nd neurosurgeon (who is the one I'm now seeing as my neurosurgeon) said that the problem there is that since I'm 46 that he could almost guarantee me that if I get a fusion that I'm looking at another fusion in 10-20 years. I do not have a herniated disc - I have 3 bulging discs. With the posterior approach he's doing both laminectomies at C5, 6 and 7 but also foraminotomies. That is the big difference as that will relieve the pressure on the nerves and nerve pain from the shoulders down are my primary pain complaints besides well my neck itself and upper back muscles. The neurosurgeon who will do the surgery on 7/12 has done a large number of this specific surgery in his internship/residency at the Mayo Clinic. He said that many just do the ACDF because it's the gold standard and they haven't been trained to do this specific procedure. He seems confident that I will not need another surgery in the future. The only one he said was a possibility but he still thinks it's unlikely would be a 1-level anterior fusion above in the future but still thinks it's unlikely as without the fusion it does't affect the level above as much. My only choice would be by going to the other neurosurgeon. I was very comfortable with my Dr's explanation, rationale, etc. for this particular surgery. After looking at my MRIs, etc he said that he feels that I'm a perfect candidate for this particular surgery. My physical therapist who is a good friend is the one who recommended this neurosurgeon and I also trust his opinion - and I felt far more comfortable with this neurosurgeon than the first one.
  • I have 3 bulging discs, DDD, bone spurs, slight spinal stenosis but it's the foraminal narrowing that's the primary issue at all 3 levels and gives the nerve pain.
  • jlrfryejjlrfrye ohioPosts: 1,110
    I have had the posterior surgery and as posted above it can be a rough recovery. I had nightmares about this surgery after my surgeon and other people telling me how bad recovery can be. It wasnt as bad as I thought it would be but like said above the muscles are the issue. Take your muscle relaxers as prescribed and walk as much as you can!!!! It keeps the muscles from tightening up. I did have trouble sleeping the first week, well not sleeping but getting up from sleeping was the issue. I had to end up getting a hospital bed at home for the first week which helped tremendously, so if given the option take your surgeon up on it. Keep us posted on how your doing
  • SwedishFishSSwedishFish Posts: 57
    edited 07/05/2012 - 7:12 PM
    Thanks for your responses. I have had a terrible time getting info on recovery expectations as most people have it with fusion. Is there anything you can remember that were particularly helpful or wish you had known before that you needed after? Shower seat? Grabber. Etc? Thanks for any specifics that you can share! Surgery is scheduled for next Thursday so I'm getting a bit nervous about it all. And I will definitely remember the tip on the hospital bed if offered. My pre-op appt is next Tues. Oh - one other question - did you guys have your head held in a 'holder' During surgery that was screwed into your head?
  • Since my surgery was at C1 and C2, my head was head in place with Mayfield pins.
  • Thank you! The other person who I know who had this surgery said that she was confused after surgery because her head was bleeding and she couldn't figure out why as they didn't tell her prior to the surgery. In the whole scheme of things good to know - just so that I'm not surprised after the fact and well I'd hate to involuntarily move in the middle of spinal surgery!
  • The sugeon told me that I'd wake up with 3 holes in the skin, they reall weren't that much of a problem as you have the large surgical wound to worry about.
    I also had a "mainline" put into my juggler vein to my heart. They told me that was simply a precaution if a air bubble go into the bloodstream to make sure it got sucked out before getting to the heart. Again that small wound didn't bother me. I did sleep in a recliner for a couple of weeks. I was driving a back at work in two weeks. My new sugeon said the sugery did add to the destabilzation of my neck and now looking at 3 level fusion but he wants to hold off as long as possible due to the 10 to 15 years for another fusion. I'm 51.
    Sending positive thoughts for a good recovery.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • Thank you so much for sharing your experience. Yea I was pretty sure about the halo-thing but couldn't find it anywhere online specifically about using them. The one person who I've gotten to know who had this surgery said that the nurse told her afterwards that nobody would have the surgery if they knew about the halo thing. HUH? I don't want any surprises personally! I am hopeful that I won't need a fusion in the future but well only time will tell. And again, since I'm 46 he for sure didn't want to do a fusion if this will do the trick. He seems confident that I won't and if so maybe a 1-level anterior fusion. But again, just have to see how stable my neck remains.

    And good to know that you were driving and at work in 2 weeks. I am a teacher and so I have exactly 5 weeks until I have to go back to school. But I have a few things planned in early August and so hoping that I'll be able to do them without any major issues (shows, not active stuff!).

    On the sleeping - guess I'll just have to see what works. But I do have a recliner option, couch option, bed, multiple different pillows so hoping something will work. One person told me that they actually were able to sleep in their bed the first night on their side. Anyway, whatever works! Thanks again for your helpful input! I really didn't mean to have multiple threads running with this same basic topic but one was older and wasn't getting hits, and then they both finally started getting some responses!

    If there's anything else that you can think of that you were so glad to have after surgery - feel free to add them!
  • jlrfryejjlrfrye ohioPosts: 1,110
    That is a item I couldnt of lived without during recovery of all 5 cervical surgeries. Trust me , you will save yourself from having to change clothes due to dribbling on yourself everytime you drink something. make sure you have a good supportive pillow to prop yourself up on, dry shampoo, If I remember correctly I wasnt allowed to wash my hair for a week and it drove me crazy knowing my hair was dirty. Soft foods for the first few days home. Oh yeah and button down shirts. They are so much easier to get on and off then something that has to go over your head. I had bought a grabber thinking I would need it but I never even used it. Good luck and keep us posted on your recovery
  • SwedishFishSSwedishFish Posts: 57
    edited 07/07/2012 - 7:03 AM
    Thanks! Someone else mentioned the straws - definitely picking some up! And thanks for the tip on button-up shirts - I may pick a few up as I don't have very many on the more casual end. I don't have to go back to school until 5 wks post-op so thinking I should be good with my "normal" clothes by then. I do have some dry shampoo on hand - funny, I bought some awhile ago and I have no idea why- but I have it so that's taken care of! I was probably going to get some of those bathing wipe things - not a ton but just enough in case I just don't feel like getting into the shower or if I can't for a day or so. I have lots of pillows although was thinking about getting one of those wedges to go underneath a pillow. Did you ever need a shower seat/stool or were you able to make do with the hand held shower nozzle? Thanks again for all of your helpful suggestions! And that's funny that you didn't use the grabber - a lot of people said it was a must have! Luckily I have a friend who will lend me one (and I'm going to ask my mom to bring hers up) and that way I don't have to buy one unless I really think I need it longer term!
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