Herniated Cervical Discs
Disc Herniation, also known as ruptured disc, is a condition that commonly occurs in the cervical spine (7 vertebrae bones making up the neck). It is one of the most common causes of neck pain. Herniated discs can be very painful, however most cases respond very good to non-surgical treatment options. Surgery might be considered if non-surgical methods don’t help the patient. There are many techniques used for the operation, and the surgeon will decide which one is the best considering the unique features the case.
Your spine is made of 24 bones called vertebrae and intervertebral discs that are located between each vertebrae. Intervertebral discs are flexible discs that are composed of Annulus Fibrous (though, outer ring of the disk) and Nucleus Pulposus (soft center of the disk). Herniated discs occur when Nucleus Pulposus disrupt the shape of Annulus Fibrous due to wear and tear caused by age or a sudden injury.
Before the Procedure
The surgeon will evaluate the overall health and medical history of the patient, and might temporarily change some medications the patient is using with other alternatives. Pre-surgical tests such as blood test and x-rays will be made several days prior to surgery. The surgeon will discuss about the patients lifestyle and perform physical examinations to find to cause of the problem.
During the Procedure
Methods of surgical treatment for herniated cervical discs are:
Anterior Cervical Discectomy & Fusion (ACDF)
Removal of bony vertebrae and discs that press on the nerves through a small incision in front of the neck. After removal, the area might be filled with bone graft and supported with a plate. The bone graft will fuse to the vertebrae around and become a solid piece of bone in a few months.
Artificial Disc Replacement
An Artificial Disc preserves the natural movement of the area. Similar to hip and knee joint implants, they are be made out of metal and plastic. Outcomes of an artificial disc is similar to ACDF, but artificial disc replacement preserves motion and may be a better choice in some cases.
It is a minimally invasive procedure that is performed through a small incision at the back of the neck. Tubes called dilators are used to create a tunnel to the vertebrae. The surgeon then removes the ruptured disc with either an endoscope or a microscope. The muscles are damaged significantly less with Microendoscopis Discectomy compared to traditional discectomy.
Posterior Cervical Discectomy
The surgeon performs the procedure through a 1-2 inch incision at the back of the neck. Spinal muscles are dissected to reach the bony vertebrae. The part of the reputed disc that is pressing on the nerve is removed.
After the Procedure & Recovery
Depending on patients age, general health and other factors, the initial healing takes around 4-6 weeks. Physical therapy can be recommended to reduce the pain and restore the mobility of the area. To avoid any future problems, patients should use proper lifting techniques, keep a good posture, a healthy weight and follow an appropriate exercise program during healing.