What is Cervical Discectomy?
Cervical discetomy is a medical procedure to treat the problems associated with the discs. When the disc bulge and disc herniation are occurring, they lead to the neck problems. And these neck problems could eventually be managed by performing such medical treatments. When the intervertebral disc is prolapsed the spinal nerves as well as the spinal cord will be compressed in the region of the neck. The result will be tingling, numbness and pain that is radiated along the arms in one or both the arms. This nerve compression can be relieved by the removal of the entire disc or only offending fragments of the disc. The cord will be restored into the normal and original size and shape.
Human spine consists of cervical segment. This segment has 7 cervical vertebrae and is separated by intervertebral discs, which are soft. These discs absorb the shocks and neck movements are well facilitated. The problems start when the water in these discs gets lost. The loss of water in these discs generally happens because of the wear and tear of these bones. Eventually the intervertebral height will be reduced and the discs will get disintegrated. Sometimes there can be formation of the bony spurs and degeneration of the body of the vertebra occurring under the vertebral body’s surface and at the same time the facet joints will be thickened. Eventually the nerve roots will be compressed because of the osteophytes encroach and disc fragments into the foramen. When these nerves are compressed, it would result in the pain.
The disc generally herniated either in the backward direction or sometimes may bulge towards the sideways. When it herniated backwards, it compresses the cord. When it bulges in the sideways, it may compress the nerve. The cord compression generally leads both the arms to become weak and experience numb. If this condition becomes sever, it affects the function of the bladder and bowel. So, the compression can be relieved either by removing either the fragments of the disc or the entire disc.
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Those patients who suffer from persistent neck pain, one or both arm pain and weakness, instability while walking and lack of bowel and bladder control in spite of taking conservative treatment methods such as rest, medication, physical therapy are ideal candidates for this procedure.
The disc may herniate backwards to compress upon the cord or it may bulge sideways to compress upon the nerve. Cord compression may lead to numbness and weakness of both arms and in severe case may affect the bowel and bladder function. This procedure aims to remove the complete disc or its fragments in order to relieve compression of the cord or nerve and restore their function.
The patient is made to lie down on his back under general anesthesia. A horizontal incision is made just 2 inches above the clavicle on either left or right side. The thin muscle layer is cut and the trachea and esophagus are shifted to one side along with the nerves and vessels. The surgeon has a clear view of the cervical vertebrae. An X-ray is done to confirm the involved disc. An operating microscope can also be used to get a better picture of the operating field. The anterior longitudinal ligament is gently removed to reach the osteophytes and the disc fragments. The osteophytes are scraped off and the intervertebral disc is dissected.
Once the disc is removed the vertebral bodies are gently distracted to their original distance to fill the space with bone graft. This helps to relieve the compression from the nerves as the diameter of the intervertebral foramen is enlarged. Sometimes cervical discectomy is followed by spinal stabilization using screws and plates.
The patient is sedated under general anaesthesia and made to lie on his abdomen. The neck is slightly bent and head is supported on the head rest. An incision is made on the back of the neck in the midline. The skin, fascia and muscles are retraced to reach the vertebrae. An X-ray is done to confirm the level of affected disc. Edges of the lamina are shaved off to give a clearer vision. In case of central herniation, both lamina may have to be removed in order to get full view of the fragmented disc.
Cervical discectomy is a surgical procedure which relieves compression on the nerve roots and/or the spinal cord because of a herniated disc or a bone spur. This procedure involves making an incision on the front side of the neck (anterior cervical spine), followed by the removal of disc material and/or a portion of the bone around the nerve roots and/or spinal cord to relieve the compression on neural structures and provide them with additional space.
Cervical discectomy is also referred to as decompressive spinal procedure as the surgeon removes compression on nerve roots by removing the total or a part of the disc and/or bony material that is causing pain. Your surgeon may choose a minimally invasive approach based on your condition and the specific surgical goals.
Minimally invasive cervical discectomy involves a small incision(s) and muscle dilation to separate the muscle fibers surrounding the spine, unlike conventional open spine surgery which requires muscles to be cut or stripped.
The advantages of Minimally invasive cervical discectomy surgery :
• Maintaining normal neck motion
• Reducing degeneration of adjacent segments of the cervical spine
• Eliminating the need for a bone graft
• Early postoperative neck motion
• Faster return to normal activity
You may want to ask some questions before your treatment begins: