Cervical surgery is performed to treat debilitating cervical conditions.
Cervical Laminectomy
This is used to treat symptoms of spinal cord compression (numbness and weakness in the arms and legs), and sometimes nerve pain in the arm as well. The surgical incision is on the back of the neck and time in hospital is a few days.
In theatre positioning of the head and neck is carefully attended to. The bones at the back of the neck are called laminae and they are revealed by separation of the muscles. A special cutting drill is used to remove the lamina bones and relieve pressure on the spinal cord. Magnification with operating loupes is used to guide this process. Sometimes stabilisation with screws and rods is also required.
A collar is generally not required. Walking is started the day after surgery. If there is pain across the shoulders it is treated with pain killers. Most people go home after a few days, but sometimes rehabilitation is needed if pre-operative function was impaired.
Cervical Foraminotomy
This surgery is performed from the back of the neck and is used to treat nerve pain in the arm due to either disc protrusion or bony spurs. A couple of days in hospital are generally needed.
In theatre positioning of the head and neck is carefully attended to. X-ray is used to find the correct spinal level and a short incision is made. The foramen is a space between the bones at the back of the neck through which the involved nerve travels. A special cutting drill is used to remove bone and reveal the nerve in its foramen. An operating microscope is used to give a clear view of the nerve and gently remove the disc fragment or bone spurs from around it. Care is taken to make sure that there is no bleeding and the wound is sutured closed. Local anaesthetic is injected into the wound during closure to help with pain relief. This process takes about one hour.
A collar is not required. Walking is started the day after surgery. If there is pain across the shoulders it is treated with pain killers. Most people go home after a couple of days.
Anterior Cervical Discectomy
This surgery is performed from the front of the neck and is usually used to treat nerve pain due to disc protrusion or bone spurs. Sometimes it is used to treat spinal cord compression. There is a short incision obliquely on one side of the neck, usually the left, and time in hospital is a few days.
In the operating theatre positioning of the head and neck is carefully attended to. Once the front of cervical spine is revealed, x-ray is used to confirm the correct spinal level. The intervertebral disc is removed back to the nerve and spinal cord. An operating microscope is used to give a clear view of the involved nerve and gently remove the disc fragment or bone spurs from around it. The space between the vertebrae is then filled with bone from the hip or a hollow cage filled with synthetic bone graft substitute. Often a plate is used to secure the graft or cage.
A collar is not required, and walking starts the next day. There will be some discomfort swallowing and this improves with time. Only a couple of days is needed in hospital.
Cervical Disc Replacement
This surgery is performed from the front of the neck and is used to treat nerve pain due to disc protrusion in carefully selected cases. There is a short incision obliquely on one side of the neck, usually the left, and time in hospital is a couple of days.
In the operating theatre positioning of the head and neck is carefully attended to. Once the front of cervical spine is revealed, x-ray is used to confirm the correct spinal level. The intervertebral disc is removed back to the nerve and spinal cord. An operating microscope is used to give a clear view of the involved nerve and gently remove the disc fragment from around it. Into the space between the vertebrae, a specially designed flexible prosthesis is inserted, and x-ray is used to show that it is in a good position.
A collar is not required, and walking starts the next day. There will be some discomfort swallowing and this improves with time. Only a couple of days is needed in hospital.
