Minimally Invasive Cervical Discectomy
A cervical discectomy is an operative procedure which relieves pressure on the spinal nerves and/or spinal cord by removing the total or a part of the damaged intervertebral disc. Cervical discectomy is performed using minimally invasive approach in selected patients, if appropriate.
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 an 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 fibres surrounding the spine, unlike conventional open spine surgery which requires muscles to be cut or stripped.
Herniated disc is a condition in which the soft, gel-like centre of the disc (nucleus pulposus) has pushed out through the disc’s tough, outer ring (annulus fibrosus). Besides, bony out growths also known as bone spurs or bone osteophytes are formed due to the accumulation of calcium in the spine joints. The pressure induced by a herniated disc or bone spur on nerve roots, ligaments or the spinal cord may cause pain in the neck and/or arms, numbness or weakness in the arms, forearms or fingers, and lack of coordination.
As most nerves to the body (e.g., arms, chest, abdomen and legs) pass through the neck region from the brain, pressure on the spinal cord in the neck region (cervical spine) can be very problematic. Patients with these symptoms are candidates for cervical discectomy procedure only after non-surgical treatment methods fail. Cervical discectomy can reduce the pressure on the nerve roots leading to pain relief.
Your surgeon recommends you for minimally invasive cervical discectomy procedure after examining your spine, medical history, and imaging results of cervical vertebrae such as X-ray, CT (computed tomography) scan or MRI (magnetic resonance imaging). Surgery is recommended only after non-surgical treatment approaches fail. Before recommending surgery, your surgeon considers several factors such as your health condition, age, lifestyle and anticipated level of activity following surgery. A thorough discussion with your surgeon regarding this treatment option is advised before scheduling the surgery.
The procedure is performed with you resting on your back after injecting the sleep inducing medication (general anaesthesia). Your physician makes a very small incision at the centre of your neck on the front side, and gently separates the muscles and soft structures apart. Then a series of small tubes called dilators are inserted through the incision towards the spine. The sources of compression such as bone spurs and/or disc material are removed. Finally, after the procedure, your surgeon removes the tubes, brings back the soft tissues and muscles to their normal place, and closes the incision.
Sometimes, spinal fusion may also be done along with cervical discectomy which involves placing bone graft or bone graft substitute between two affected vertebrae to allow bone to grow between the vertebral bodies. The bone graft acts as a platform or a medium for binding the two vertebral bones, and grows as a single vertebra which stabilizes the spine. Spinal fusion also may be performed through the minimal invasive approach using “tubes”.
In some instances, your surgeon performs the surgery using a posterior approach that requires the incision to be made on the back of your neck. Posterior cervical discectomy may also be done using minimally invasive surgical technique.
A specific post-operative recovery/exercise plan will be given by your physician to help you return to normal activity at the earliest. After surgery, your symptoms may improve immediately or gradually over the course of time. The duration of hospital stay depends on the treatment plan. In a few instances, surgery may also be performed on an outpatient basis. You will be able to wake up and walk by the end of the first day after the surgery. Your return to work will depend on your body’s healing status and the type of work/activity that you plan to resume. Discuss with your spinal surgeon and follow his instructions for optimized healing and appropriate recovery after the procedure.
Risks or Complications
All surgeries carry risk and it is important to understand the risks of the procedure in order to make an informed decision to go ahead with the surgery. In addition to the anaesthetic complications, spinal surgery is associated with some potential risks such as infection, blood loss, blood clots, nerve damage, and bowel and bladder problems. Failure to fuse the vertebral bones with the bone graft (fusion failure) is an important complication of spinal fusion which requires an additional surgery.
Before scheduling the surgery, discuss the benefits, risks and complications related to minimally invasive cervical discectomy procedure with your surgeon.