Cervical Discectomy

What is Cervical Discectomy?

A cervical discectomy is a surgical procedure performed to remove a herniated or degenerated disc from the cervical spine (neck region). The procedure involves making an incision in the front(majority) or back of the neck and carefully removing the damaged disc to relieve pressure on the spinal cord or nerves. A small amount of bone may also be removed to access the damaged disc.

After the damaged disc is removed, the surgeon may replace it with an artificial disc or use a bone graft/cage to fill the space left by the removed disc. This can help maintain the disc space's normal height and prevent further degeneration of the adjacent discs.

Why is it done?

A cervical discectomy is performed for cervical disc prolapse.

Cervical disc prolapse, also known as a herniated or slipped disc, is a condition that occurs when one of the discs between the cervical vertebrae in the neck slips out of its normal position and protrudes or bulges into the spinal canal. Spinal discs act as cushions between the vertebrae of the spine, enabling flexibility and movement of the spine.

This can cause pressure on the spinal cord or nerves, resulting in pain, weakness, numbness, or tingling sensations in the neck, shoulders, arms, and hands. The severity of the symptoms varies depending on the prolapse's size and location, ranging from moderate to severe.

Surgery is unnecessary for most people with cervical disc prolapse, as natural healing can occur within 6-8 weeks or with the help of image-guided steroid injections.
Approximately six out of ten patients will improve naturally within six weeks, while 7-8 out of 10 patients will feel better within three months.
Surgery is usually only considered by doctors if the pain is severe and has not improved with pain relief or if there are signs of nerve damage.
Spinal surgery cannot cure or prevent disc degeneration but aims to improve symptoms, and around 85-90% of cases will experience relief from arm pain, usually over time. However, relief from neck pain is more difficult to predict and is not the main aim of the surgery.

What happens during the anterior cervical discectomy procedure?

Before the procedure, the patient will typically undergo a thorough evaluation by the surgeon to determine the underlying cause of their pain and whether a cervical discectomy is an appropriate treatment option. This will also include an anaesthetic assessment for fitness for surgery.

The surgery is usually performed under general anaesthesia, and the patient lies face-up on the operating table.

The surgeon then uses a microscope/ surgical loupes and specialized instruments to remove the portion of the disc that is compressing the spinal nerves. Magnification has its advantages like enhanced visualisation, improved precision, reduced trauma, and quicker recovery (reduced trauma and small incisions).

Surgery aims to remove the disc and material (for example, the excess bone and ‘thickened’ ligament) from the front of the spinal canal to give the spinal cord and nerves more room.

After the damaged disc is removed, the surgeon may replace it with an artificial disc or use a bone graft/cage with a plate and screws to fill the space left by the removed disc.

The procedure typically takes one or more hours, depending on the extent of the stenosis and the case's complexity.

What happens after the procedure?

After the procedure, the patient is taken to a recovery room, where they are monitored briefly before discharge. Patients can usually return home after safely mobilising following the surgery. Depending on the case's complexity, this may be a day or a few days.

Patients are given pain medications to manage the discomfort. They may also be instructed to avoid bending, lifting, or twisting their neck for several weeks. Patients may need to undergo physical therapy to strengthen their neck muscles and improve their range of motion. The recovery period varies for each patient, but most people can return to work within 2-6 weeks after surgery, depending on the nature of their job.
If necessary, physical therapy is typically initiated after the surgery to enhance the patient's strength and flexibility.

What are the potential side effects of the procedure?

As with any form of surgery, there are risks associated with it. These are nerve root damage, spinal cord damage, dural tear, recurrence, bleeding, infection, ongoing pain, blood clots in legs/lungs, non-union, stroke, heart attack, medical or anaesthetic problems or death.
These risks and benefits will be discussed in detail during the consent process.

Please take your physician's advice for a complete list of indications, clinical results, adverse effects, warnings and precautions, and other relevant medical information about the anterior cervical discectomy with fusion surgery.

Please follow the BASS (British Association of Spinal Surgeons) website for more information.

Learn more about spinal conditions:

Cervical Disc Prolapse: Understand a prevalent condition treated by cervical discectomy, where a neck disc herniates.
Cervical Disc Myelopathy
: Explore the causes and symptoms associated with Cervical Disc Myelopathy.