Cervical spine surgery
Cervical spine surgery is the treatment of an issue found in the cervical region of the spine. The problem usually involves misalignment, nerves that are compressed, or an abnormal spinal cord. There are various surgical procedures to treat in an order-like method such as cervical degenerative disc disease, cervical facet joint degeneration, cervical herniated discs, cervical stenosis with myelopathy, cervical spondylolisthesis, and spondylosis.
Some common kinds of cervical spine surgery include:
Decompression- Decompression is done with the purpose of removing the pressure caused on the spinal cord or nerves in the neck.
– Fusion: This type of surgery corrects instability in the cervical spine by fusion, which sets up the process for a solid bony bridge to form between the vertebrae.
Disc replacement: This procedure involves removal of the dysfunctional disc with an artificial disc implant replacing it.
Common Conditions Treated by Cervical Spine Surgery:
- Cervical Disc Herniation: The soft, inner material of a cervical disc can bulge or rupture, pressing on the spinal cord or nerve roots.
- Cervical Spinal Stenosis: Narrowing of the spinal canal, leading to compression of the spinal cord or nerves.
- Degenerative Disc Disease: Age-related wear and tear on the cervical discs, causing pain and nerve compression.
- Cervical Spondylosis: A type of arthritis in the neck that can cause bone spurs and disc degeneration, leading to spinal cord or nerve root compression.
- Cervical Myelopathy: A condition in which the spinal cord is compressed, often due to stenosis or disc herniation, leading to weakness, numbness, or coordination problems.
- Cervical Radiculopathy: Nerve pain radiating from the neck into the shoulders, arms, or hands due to nerve root compression.
- Cervical Fractures or Instability: Trauma to the neck or degenerative conditions can lead to spinal instability, necessitating surgery.
Types of Cervical Spine Surgeries:
- Anterior Cervical Discectomy and Fusion (ACDF):
- Most common cervical spine surgery.
- Involves removing a damaged or herniated disc through an incision in the front (anterior) of the neck.
- After the disc is removed, the surgeon inserts a bone graft or synthetic spacer to maintain the height between the vertebrae.
- A plate and screws are often used to stabilize the vertebrae while they fuse together over time.
- Posterior Cervical Laminectomy:
- Performed through an incision in the back (posterior) of the neck.
- The lamina (the back part of the vertebra) is removed to create more space for the spinal cord and nerves, relieving compression caused by stenosis or myelopathy.
- May be combined with fusion if spinal instability is present.
- Cervical Disc Replacement:
- Instead of fusing the vertebrae, this surgery involves removing a damaged disc or replacing it with an artificial disc.
- Maintains more natural movement in the cervical spine compared to fusion.
- Often used as an alternative to ACDF in select patients.
- Anterior Cervical Corpectomy:
- Involves removing part of a vertebra and the adjacent discs to decompress the spinal cord.
- A bone graft or cage is placed to fill the gap, and the spine is fused to stabilize the area.
- Cervical Foraminotomy:
- A minimally invasive procedure to enlarge the foramen (the opening where the nerve roots exit the spine) to relieve nerve root compression (radiculopathy).
- Can be done from the front (anterior) and back (posterior) of the neck.
- Posterior Cervical Fusion:
- Fusion of the cervical vertebrae from the back of the neck to stabilize the spine in cases of instability, fractures, or deformities.
Procedure of Cervical Spine Surgery:
- Anesthesia: The surgery is performed under general anesthesia.
- Incision: Depending on the type of surgery, the incision may be made on the front (anterior) and back (posterior) of the neck.
- Decompression: The surgeon removes the disc, bone spurs, or other tissues that are compressing the spinal cord or nerve roots.
- Stabilization (if necessary): If fusion is required, bone grafts, cages, plates, or screws are used to stabilize the vertebrae.
- Closure: The incision is closed with sutures or staples, and a neck brace may be applied.
Recovery from Cervical Spine Surgery:
- Hospital Stay: Depending on the complexity of the surgery, patients may stay in a hospital for 1–3 days.
- Postoperative Pain: Pain and discomfort in the neck and shoulders are common after surgery, and pain medications are prescribed to manage this.
- Physical Therapy: Once the initial healing has occurred, physical therapy is often recommended to restore strength and mobility.
- Activity Restrictions: Patients are usually advised to avoid heavy lifting, strenuous activity, and driving for several weeks after surgery.
- Neck Brace: Some patients may need to wear a neck brace to support the spine during recovery.
Risks and Complications:
While cervical spine surgery is generally safe, it carries risks, including:
- Infection: An infection may occur at the surgical site.
- Bleeding or Hematoma: Accumulation of blood near the surgical area can cause complications.
- Nerve or Spinal Cord Injury: Though rare, there is a risk of damage to the spinal cord or nerves, which can lead to neurological symptoms.
- Dysphagia: Difficulty swallowing is a common side effect, particularly after anterior cervical surgery.
- Non-Union: In fusion surgeries, the vertebrae may fail to fuse, requiring further treatment or surgery.
- Hoarseness: Some patients experience changes in their voice due to nerve irritation near the vocal cords.
- Adjacent Segment Disease: Over time, adjacent vertebrae may experience increased stress, leading to degeneration.
Success Rate and Prognosis:
- The success rate of cervical spine surgery is generally high, particularly for conditions like cervical disc herniation or radiculopathy.
- Most patients experience significant pain relief and improvement in function after surgery.
- Full recovery can take several weeks to months, depending on a type of the surgery or the patient’s overall health.
- Surgery for myelopathy (spinal cord compression) can stop the progression of symptoms and improve neurological function, though some patients may have residual symptoms.
Who Needs Cervical Spine Surgery?
In most cases, a cervical spine operation is indicated in patients who did not improve with conservative measures that could include physical therapy, medications, or even injections.
- She experienced numbness, weakness, or pain in the legs, on both sides, which, to a significant degree, interfered with her use of daily activity.
- Presents with progressive neurological signs or symptoms due to compression of the spinal cord.
- Spinal instability or fractures.
Alternatives to Surgery:
Before recommending surgery, doctors often explore non-surgical treatments, such as:
- Physical Therapy: Strengthening and stretching exercises to relieve pressure on the cervical spine.
- Medications: Pain relievers, muscle relaxants, or anti-inflammatory drugs can help manage symptoms.
- Epidural Steroid Injections: Injections near the affected nerves to reduce inflammation and relieve pain.
- Chiropractic Care: Some patients benefit from spinal manipulation or adjustments.
- Acupuncture or Massage Therapy: These alternative therapies may provide pain relief.
What procedures Cervical spine surgery?
The following are some of the procedures used in cervical spine surgery :
– Decompression: This technique is done to “decompress” the spinal cord or nerves in the neck by dictionary a piece of bone, disc, or other structure
compressing the neural tissue.
– Discectomy: This procedure dictionary a herniated disc to treat degenerated, herniated or ruptured spinal discs.
– Disc replacement: This surgery removes the entire damaged disc and replaces it with the artificial disc implant.
– Foraminotomy: This procedure widens the opening where a spinal nerve roots exit through the spine.
– Laminectomy: This procedure removes the entire lamina of the vertebra.
– Laminoplasty: This procedure opens the lamina instead of a removing it.
– Fusion: This surgery corrects instability in the cervical spine through fusion, which sets up the process for the solid bony bridge to form between the vertebrae.
– Neck fusion surgery: This procedure joins two cervical vertebrae. This permanently stops movement between a two bones.
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.