Cervical spine disc surgery (cervical spine) is asurgical procedure to treat a herniated disc in the cervical spine. The procedure can be performed from the front (neck side) or from the back (neck side). The operation is usually performed by a neurosurgeon. The aim of disc surgery on the cervical spine is to relieve the constricted spinal cord nerves.
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Article overview
- Causes and symptoms of a herniated disc in the cervical spine
- Conversational treatment of a herniated disc in the cervical spine
- Indications for disc surgery on the cervical spine
- How disc surgery on the cervical spine works
- Diagnosis and preliminary examinations before the procedure
- Anesthesia, duration and hospital stay
- Procedure for disc surgery on the cervical spine
- Risks associated with disc surgery on the cervical spine
- Aftercare and rehabilitation following disc surgery on the cervical spine
Intervertebral disk surgery to the cervical spinal column - Further information
A herniated disc in the cervical spine (cervical disc herniation) results in a sudden or slowly increasing displacement of the disc. This leads to a constriction of the spinal cord nerves.
The disc tissue protrudes through the completely or partially torn fibrocartilage ring of the disc into the spinal canal (spinal canal, spinal cord canal). There it presses on the nerve roots and the spinal cord.
Such a cervical disc herniation is often accompanied by spinal canal stenosis - a narrowing of the spinal canal in the cervical spine.
The cervical spine is the uppermost section of the spine located in the neck @ FGWDesign /AdobeStock
Causes and symptoms of a herniated disc in the cervical spine
Thecause of a herniated disc in the cervical spine is wear and tear of the disc cartilage. This loses water and elasticity over the course of a lifetime and therefore becomes brittle.
A herniated disc in the cervical spine most frequently occurs between the 5th and 6th and between the 6th and 7th cervical vertebrae.
It usually manifests itself as pain in the shoulder and neck area, which extends over the upper and lower arm into the fingers. Restricted movement of the cervical spine is also possible.
The following neurological symptoms can occur in the neck, shoulder and arm:
- Paralysis
- Muscle weakness
- sensory disturbances
- gait disorders
Conversational treatment of a herniated disc in the cervical spine
In most cases, it is sufficient to treat a herniated disc in the cervical spine conservatively (without surgery).
If there are no neurological deficits, but only pain in the shoulder/neck area, conservative treatment is recommended initially.
This usually consists of
- Physical rest
- Physiotherapy under supervision and
- Regular intake of medication for pain and muscle tension
These measures often lead to a significant reduction in pain and restricted movement.
Indications for disc surgery on the cervical spine
Surgery is only necessary if conservative therapy does not lead to any improvement in the symptoms. Even if there are neurological symptoms in addition to pain.
In the case of moderate to severe paralysis in the arms and gait disorders with the threat of paraplegia, disc surgery is urgently recommended.
If mild symptoms of paralysis and pain persist for longer than 3 to 4 weeks despite conservative treatment, surgical treatment should also be carried out.
How disc surgery on the cervical spine works
Disc surgery on the cervical spine is usually performed by a specialist in neurosurgery. The aim of disc surgery on the cervical spine is to relieve and free the constricted spinal cord nerves from pressure.
To achieve this, the neurosurgeon removes either part of the disc material or the entire disc using a surgical microscope.
The affected area of the cervical spine is accessed either from the neck or from the side of the neck.
Diagnosis and preliminary examinations before the procedure
In the run-up to disc surgery, the doctor takes the patient's medical history (anamnesis) and carries out a detailed physical examination.
This includes in particular
- X-ray examinations of the cervical spine
- Electrophysiological examinations of the nerve roots (to determine the nerve conduction velocity)
- Magnetic resonance imaging of the cervical spine and
- A computer tomography of the cervical spine
Anesthesia, duration and hospital stay
As this is an inpatient operation, the patient is admitted to hospital the day before the procedure.
Disc surgery on the cervical spine is performed as an inpatient under general anesthesia and takes between 60 and 90 minutes. Regardless of whether it is performed on the neck or the nape of the neck.
After the operation, the patient spends about an hour and a half in the recovery room. They are then cared for on the normal ward.
Depending on the patient's condition, the operation is followed by a hospital stay of 4 to 6 days.
Procedure for disc surgery on the cervical spine
Disc surgery on the cervical spine is a minor procedure that is performed using a surgical microscope.
Two surgical options are available. The affected cervical vertebrae can be accessed as follows:
- From the front (neck side) or
- From the back (neck side)
Which procedure is used depends on the location of the herniated disc. In most cases, neurosurgeons perform disc surgery from the side of the neck.
- Approach from the neck side
If the procedure is performed from the side of the neck,the patient lies on their back during the operation. At the beginning of the operation, the neurosurgeon makes a 4-centimeter-long, transverse incision at the level of the cervical spine. He splits the flat cervical muscle plate.
He then moves the neck muscles, arteries and veins to the side so that he has a clear view of the front of the cervical spine.
Using the operating microscope, the neurosurgeon now begins to remove the herniated disc. The surgeon must be careful not to damage the spinal cord and nerve fibers.
Finally, he inserts a disc prosthesis into the empty space created by the removal of the disc.
- Access from the side of the neck
If the disc surgery is performed from the side of the neck, the patient is in a semi-sitting position during the operation. They lie on their stomach.
At the beginning of the operation, the neurosurgeon makes a 4 to 5 centimeter long, straight incision on the spinous processes.
He then carefully pushes the neck muscles to the side so that the neurosurgeon has a clear view of the intervertebral disc.
Using a surgical microscope, the neurosurgeon removes parts of the vertebral arch of the two adjacent vertebrae. He also removes the prolapsed disc material that is constricting the nerve root.
During this operation, the surgeon must also ensure that neither the spinal cord nor the nerve fibers are damaged.
The stability of the spine is not impaired by the missing pieces of bone and the removed disc material.
Risks associated with disc surgery on the cervical spine
Complications and risks associated with disc surgery on the cervical spine are rare.
In rare cases, the following complications can occur when approaching from the neck side:
- Injuries to the major neck vessels and nerves
- Injuries to the trachea and oesophagus
- Injuries to the spinal cord and nerve roots (very rare)
If the surgeon has injured the decompressing nerve during the intervertebral disc operation, this can lead to sensory and movement disorders in the legs, among other things.
There are also general surgical risks, such as
- Danger of wound infection
- Wound healing disorder
- Post-operative bleeding in the surgical area
Aftercare and rehabilitation following disc surgery on the cervical spine
Disc surgery on the cervical spine is usually followed by a hospital stay of 4 to 6 days.
The patient should take it easy physically for the first 4 to 6 weeks after being discharged from hospital.
After this time, the patient is able to bear normal weight again. After around 8 weeks, the patient can begin outpatient physiotherapy to specifically build up the neck and cervical muscles.
If necessary, medication can also be taken to relieve pain and muscle tension.