Minimally Invasive Cervical Discectomy
Disease Overview
The vertebrae of the backbone are cushioned by intervertebral discs that act as shock absorbers and allow frictionless movement of your back. It is made up of a soft gel-like center called the nucleus pulposus that is surrounded by a tough outer ring of annulus fibrosus. A herniated disc is a condition in which the nucleus pulposus bulges out through the damaged or broken annulus fibrosus. This puts pressure on the neural structures, such as nerve roots and/or the spinal cord. Besides, bony outgrowths also known as bone spurs or bone osteophytes can form due to the accumulation of calcium in the spine joints. The pressure induced by a herniated disc or bone spur on nerve roots, ligaments or the spinal cord may cause pain in the neck and/or arms, numbness or weakness in the arms, forearms or fingers, and lack of coordination.
As most nerves to the body (e.g., arms, chest, abdomen and legs) pass through the neck region from the brain, pressure on the spinal cord in the neck region (cervical spine) can be very problematic.
What is Minimally Invasive Cervical Discectomy?
A cervical discectomy or decompressive spinal procedure is an operative procedure that relieves pressure on the spinal nerves and/or spinal cord by partially or completely removing the intervertebral disc that is herniated and/or bony material (bone spur). Cervical discectomy can be performed using a minimally invasive approach if you are suitable.
This procedure involves making an incision on the front side of the neck (anterior cervical spine), followed by the removal of disc material and/or a portion of the bone around the nerve roots and/or spinal cord to relieve the compression and provide them with additional space.
Minimally invasive cervical discectomy involves a small incision(s) and minimal muscle dilation to separate the muscle fibers surrounding the spine, unlike conventional open spine surgery, which requires muscles to be cut or stripped.
Diagnostic Tests Ordered before Minimally Invasive Cervical Discectomy
Your surgeon recommends you for minimally invasive cervical discectomy procedure after examining your spine, medical history and imaging results of cervical vertebrae such as X-ray, CT (computed tomography) scan or MRI (magnetic resonance imaging).
Indications for Minimally Invasive Cervical Discectomy
Minimally invasive cervical discectomy is recommended only after non-surgical treatment approaches fail. Before recommending surgery, your surgeon considers several factors such as your health condition, age, lifestyle and anticipated level of activity following surgery.
Minimally Invasive Cervical Discectomy Procedure
Minimally invasive cervical discectomy is performed with you resting on your back under general anesthesia. Your physician makes a very small incision at the center of the front side of your neck and gently separates the muscles and soft structures apart. Then a series of small tubes called dilators are inserted through the incision towards the spine. The sources of compression such as bone spurs and/or disc material are removed. Finally, after the procedure, your surgeon removes the tubes, brings back the soft tissues and muscles to their normal place, and closes the incision.
Sometimes, spinal fusion may also be done along with cervical discectomy which involves placing bone graft or bone graft substitute between two affected vertebrae to allow the bone to grow between the vertebral bodies. The bone graft acts as a platform or a medium for fusing the two vertebral bones so that it grows as a single vertebra to stabilize the spine. Spinal fusion may also be performed through the minimally invasive approach.
In some instances, your surgeon performs the surgery using a posterior approach that requires the incision to be made on the back of your neck. Posterior cervical discectomy may also be carried using a minimally invasive surgical technique.
Postoperative Instructions following Minimally Invasive Cervical Discectomy
A specific postoperative recovery/exercise plan will be provided by your physician to help you return to normal activity at the earliest. After surgery, your symptoms may improve immediately or gradually over the course of time. The duration of your hospital stay depends on the treatment plan.
In a few instances, surgery may also be performed on an outpatient basis. You will be able to wake up and walk by the end of the first day after the surgery. Your return to work will depend on your body’s healing ability and the type of work/activity that you plan to resume.
Risks or Complications of Minimally Invasive Cervical Discectomy
All surgeries carry risks and it is important to understand the risks of the procedure to make an informed decision to go ahead with the surgery. In addition to the anesthetic complications, spinal surgery is associated with some potential risks such as infection, blood loss, blood clots, nerve damage, and bowel and bladder problems. Failure to fuse the vertebral bones with the bone graft (fusion failure) is an important complication of spinal fusion, which usually requires additional surgery.
Before scheduling the surgery, discuss the benefits, risks, and complications related to minimally invasive cervical discectomy procedure with your surgeon.