Dr. Zeeshan Sardar, MD, MSc, F.R.C.S.C
Director, Quality & Patient Safety (QPS) – Och Spine Hospital
Medical Director, Spine Unit – Och Spine Hospital
Co-Chief of Spinal Deformity Surgery • NewYork-Presbyterian / Columbia University
Och Spine Hospital • New York, NY
Posterior cervical laminectomy and fusion (PCLF) decompresses the spinal cord by removing the posterior bony arch of the cervical vertebrae from behind and stabilizes the spine with instrumentation and fusion. It is the procedure of choice for multilevel cervical stenosis with myelopathy when the patient has cervical kyphosis or instability that makes laminoplasty unsuitable, or when the number of levels requiring decompression exceeds what can safely be addressed from the front.
WHEN IS PCLF USED?
- Multilevel cervical stenosis with myelopathy
- Cervical kyphosis requiring decompression and stabilization
- Cervical instability from degenerative disease, inflammatory arthritis, or prior surgery
- Multilevel OPLL when posterior decompression is appropriate
- Revision of prior ACDF with adjacent segment disease extending over multiple levels
- Combined anterior-posterior approach when anterior decompression alone is insufficient
LAMINECTOMY AND FUSION VS. LAMINOPLASTY
Both decompress the spinal cord from behind for multilevel stenosis. Laminoplasty preserves the laminae and does not require fusion; PCLF removes the laminae entirely and requires fusion to prevent postoperative instability. PCLF is preferred when cervical kyphosis is present, when instability requires fusion, or when severity of compression makes laminoplasty technically unsuitable. PCLF provides more definitive stability and may allow correction of alignment; laminoplasty preserves more motion.
THE PROCEDURE
PCLF is performed through a posterior midline incision with the patient prone. Lateral mass screws and/or pedicle screws are placed under robotic-assisted navigation. Rods connect the screws to stabilize and, if needed, correct alignment. Bone graft is placed to promote fusion. Intraoperative neuromonitoring is used throughout.
FREQUENTLY ASKED QUESTIONS
How is PCLF different from laminoplasty?
Laminoplasty hinges the lamina open and preserves it without fusion; PCLF removes the lamina entirely and requires fusion. PCLF is generally chosen when kyphosis or instability is present, since laminoplasty depends on preserved alignment to work effectively.
Will I lose neck motion after PCLF?
Yes, motion is eliminated at the fused levels. Because PCLF is generally used for more extensive disease, the trade-off in motion is accepted in exchange for more definitive stability and decompression.
Can PCLF correct cervical kyphosis?
To a meaningful degree, yes. Because the construct is rigid and instrumented, some correction of alignment can be achieved during the procedure, which is one reason it is preferred over laminoplasty when kyphosis is present.
How long is recovery?
Most patients are hospitalized for 2 to 3 days. Return to light activity is typically 4 to 6 weeks, with neurological recovery from myelopathy continuing more gradually over several months.
Is navigation used for this procedure?
Yes, sometimes, navigation is used as standard for pedicle screw placement, supporting precision in this region of the spine.
WHY CHOOSE DR. SARDAR
Dr. Sardar performs the full spectrum of cervical surgery and selects the approach based on each patient’s anatomy, alignment, and pathology. His training in both orthopedic and neurosurgical spine surgery gives him a uniquely comprehensive technical foundation for cervical reconstruction. Robotic navigation and intraoperative neuromonitoring are standard at the Och Spine Hospital at NewYork-Presbyterian.
This page is for educational purposes only and does not constitute individualized medical advice.
RELATED CONDITIONS & PROCEDURES
- Cervical Laminoplasty — motion-preserving posterior decompression for multilevel stenosis with preserved lordosis
- Cervical Myelopathy Surgery — spinal cord compression in the neck; overview of all surgical approaches
- ACDF Surgery — anterior cervical fusion for 1–3 level disease; often combined with posterior surgery for complex cases
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