Cervical Discectomy FAQs

Cervical Discectomy

What is a herniated disc?

The disks in the spine are “gel-filled” cushions between the vertebras of the spine.  When there is a tear in the outer layer of the gel that fills the disk leaks out.  A herniated disk can put pressure on the nerves or spinal cord and lead to pain, numbness or weakness.

What is the difference between a bulging disc and a herniated disc?

The terms herniated disc and bulging disc are sometimes used interchangeably, and the symptoms are similar, but there are differences between the two.

When a disk is bulging, there is no tear in the outer layer.  A bulge, or bubble, in the disk surface puts pressure on the nerves and causes pain, numbness or weakness, but there is no fluid leakage.

When a disk is herniated, there is a rupture in the outer layer of the disk which allows the gel in the center of the disk to leak out.  Herniated disks often start out as bulging disks.

What’s the difference between cervical disc arthroplasty vs. anterior cervical discectomy and fusion?

Cervical disk arthroplasty uses an artificial material to replace the removed disk while anterior cervical discectomy and fusion uses a bone graft to fill in the space.  Both procedures have better than a 90% rate of success in relieving pain and other symptoms.  The primary benefit to cervical disk arthroplasty is that there is no risk of graft complications, such as the graft failing to fully heal and integrate into the spine.

Can whiplash cause a herniated disc?

Whiplash is caused by an abrupt motion or snap in the neck.  If the impact is severe enough or if the disks in the neck are already predisposed to bulging or degeneration the whiplash can lead to herniation of a disk.

Why is surgery done through the front of the neck?

Cervical spine surgery is typically done through the front of the neck to allow for easy access to the spine and to reduce the risk of damage to the spinal cord.

What effect does a fusion have on the rest of the cervical spine?

If the fusion of the cervical vertebra does not occur in proper alignment, it can affect the curvature of the lower spine and the way that weight is distributed.  Over time, this can lead to tension and pain in the lower back and an increased risk of disk failure in that region of the spine.

Should I have allograft or autograft bone?

Both allograft and autograft bone grafts have advantages and disadvantages.  The options should be discussed with your physician and surgeon.

  • Allograft – Allograft bone comes from a deceased donor. The bone is collected from organ donors after death.  The graft does not have active cells; instead, the hollow of the bone is packed with tissue from your spine that is collected during the procedure.  The use of Allograft bone prevents the need to remove bone from the patient’s hip to perform the procedure.
  • Autograft – Autograft bone comes from the patient. Bone cells are taken from the patient’s hip.  Autograft bone has a better rate of fusion since it contains living cells.  Autograft has the disadvantage or requiring a second incision and bone removal in the hip which increases the risk of pain and infection.

What are advantages of an anterior cervical discectomy and fusion?

Accessing the spine through the front of the neck is minimally invasive and offers several benefits.

  • Direct and easy access to the cervical spine.
  • Reduced risk of trauma to the spinal cord.
  • Less pain during recovery.
  • Reduced risk of blood loss and infection.
  • Quicker recovery time.

 

What are some reputable hospitals that specialize in cervical discectomy?

There are many well equipped and highly qualified hospitals in India that specialize in cervical discectomy and fusion and the costs of a fraction of those that a patient would pay for the same quality of service in the United States.

What is an ACDF operation?

Anterior Cervical Discectomy is a surgery performed to remove a damaged, degenerative or herniated disk in the neck.  An incision is made in the front of the neck, the damaged dick, or partial disk is removed and a graft is inserted in its place.  The surgery is performed to alleviate pain in the neck, upper back and arms associated with the damaged disk.

What are some common indications for Cervical Spine surgery?

Your doctor may recommend cervical spine surgery if there is major weakness in the arm or hand, if there is arm pain combined with neck pain and if the arm pain is greater than the pain in the neck.  If these conditions do not respond to medication and physical therapy your doctor will perform imaging tests such as an MRI or CT scan to determine if there is a herniated or degenerative disc.

How long will it take to recover from anterior cervical fusion surgery?

The recovery time associated with anterior cervical fusion is unique for each patient. Many factors affect recovery including pre-existing health conditions and age.  On average, a patient will begin physical therapy within four to twelve weeks of the procedure.  Physical therapy can last up to twelve weeks and may be extended based on the patient’s recovery and needs.  Following the conclusion of physical therapy, the patient should speak with their doctor about any limitations to activity and exercise that may be required.

Will delaying surgery cause irreversible damage?

If the nerves or spinal cord are compressed by the damaged disk over a long period of time permanent damage may occur.  Whether surgery can be delayed should be discussed with your physician who will examine CT or MRI images to determine the extent of the damage and pressure on the nerves and spinal cord, and your condition, and if the surgery can be delayed.

How Is An Anterior Cervical Discectomy With Fusion Performed?

During anterior cervical discectomy an incision is made in the front of the throat to access the spine. The surgeon removes the disk, or disks, that are degenerative or herniated.  After the disk is removed a graft is implanted in the empty space to support the vertebrae and to serve as a bridge for spinal fusion. As the body heals new bone grows around the graft fusing the vertebrae with solid bone.

Are there any potential risks or complications of cervical discectomy?

Complications associated with cervical discectomy are rare but no surgical procedure is completely without risks.  Some of the complications that have been reported include:

  • Damage to the vertebral or carotid artery that can lead to excessive bleeding, stroke or death.
  • Damage to the superior or recurrent laryngeal nerve which can affect the tone of the voice and the ability to swallow.
  • Cerebral spinal fluid leak.
  • Damage to the nerves or spinal cord which can lead to loss of sensation, weakness, impaired function or paralysis.
  • Failure of the implanted graft (migration or breakage)
  • The development of pseudoarthrosis (associated with inadequate fusion)

What is the success rate of anterior cervical discectomy and fusion?

Anterior cervical discectomy and fusion is over 93% effective in reliving arm pain and over 73% effective in relieving neck pain.

What are the common questions to ask from neurosurgeon before cervical spine surgery?

Undergoing surgery can be scary and create anxiety in the patient.  The best way to deal with this fear and anxiety is to be well informed.  Here are some questions to ask your doctor before agreeing to undergo spinal surgery.

  • Is there an alternative to having surgery?
  • What are the risks associated with surgery?
  • What are the benefits associated with surgery?
  • How long will I remain in the hospital following the surgery?
  • How long is the recovery period?
  • How much experience have you had with this procedure?
  • What are the possible consequences of not having the surgery?