Cervical Spine / Neck Options
Discectomy is the removal of the herniated portion of a disc to relieve the pressure on nearby nerves as they exit the spinal canal.
Contrary to myths, the disc does not slip out of position like a watermelon seed. Instead, the disc is like a jelly donut, acting as the functional shock absorber between two bony vertebrae. An injury, damage from a lifting incident or a twist may cause the jelly center to break through the wall of the disc. When a disc herniates, the jelly center can press on nearby nerves. In the neck, this causes arm, shoulder, scapula and, in extreme cases, spinal cord compression.
Posterior Cervical Foraminotomy / Discectomy
For some herniated discs or bone spurs in the neck affecting only the nerve roots, a posterior discectomy and foraminotomy can be performed. This avoids spinal fusion, and with a microscope or a minimally invasive technique, can minimize recovery time and speed a patient back to work or activities.
Anterior Cervical Discectomy
Cervical is the medical term for “neck.” Just as in a lumbar discectomy, the surgeon will remove a piece of damaged disc tissue in the neck area to relieve pressure on the spinal cord or nerve roots. In some cases, by removing a piece of the shock-absorbing disc that separates the two vertebrae, the structures may become less stable. Consequently, when the disc is removed, a surgeon may recommend “fusing” the vertebrae to prevent instability. A cervical discectomy is best left to surgeons who specialize in spine.
A corpectomy is often performed for patients suffering from multiple levels of cervical stenosis with cord compression. The goal of a corpectomy is complete decompression of the spinal canal when stenosis encompasses more than just disc space and has moved into vertebral bodies.
Bone spurs forming toward the back of a vertebral body or the ligament behind vertebral bodies can cause the cervical spinal canal to narrow. Therefore, it may be necessary to remove one or more degenerating vertebrae and the discs above and below in order to decompress the spinal cord and nerve roots.
A corpectomy involves a vertical incision in the neck. The middle portion of the vertebra and its adjacent discs are removed to achieve decompression of the cervical spinal cord and nerve roots. A fusion accompanies a corpectomy surgery, using bone harvested from the patient’s hip or from a bone bank. This bone graft is used to reconstruct the spine and provide stability.
Anterior Cervical Fusion
A fusion accompanies a anterior cervical discectomy or corpectomy. During fusion surgery, a disc Is removed, and the surgeon inserts a small wedge of bone between two vertebrae to restore disc space. Over time, the two vertebrae “fuse” together into a single solid structure. While this procedure limits movement and flexibility, it also helps relieve relieve neck pain.
Bone graft for the purpose of spinal fusion may be harvested from the patient’s hip (autograft bone), from a cadaver bone (allograft bone), or from synthetic bone graft substitutes, which are currently being developed more extensively. Your surgeon will help you decide what is best for you.