Anterior cervical discectomy is used to treat symptoms when a cervical disc pushes on the spinal cord or nerves in the neck. Symptoms may include pain in the neck and the arm, weakness and sensory disturbance. Pressure on the spinal cord can also cause problems with walking and if severe, cause bladder and bowel dysfunction.
Surgery is performed to relieve pressure on the spinal cord and nerves by removing portions of the damaged disc. The disc is removed to create more space for the nerves and spinal cord.
The most common levels to be affected in the neck are at the C6-7 and the C5-6 levels. Occasionally, some patients may have two levels that require surgery and in extreme cases, even 3 or 4.
The anterior exposure through the front of the neck allows access to the cervical spine from C2 down to C7. It usually results in less post-operative pain as there is less disturbance to muscle and surrounding tissues compared with surgery posterior in the neck.
A skin incision of 2cm is performed in a skin crease to enhance the cosmetic result of the surgery. The muscles and blood vessels and other structures of the neck are moved out of the way to expose the front portion of the disc. Small instruments are then used to remove the disc and relieve the pressure on the spinal cord and the nerve. Loose fragments of disc and bone spurs can be removed if these are causing compression. There is little or no manipulation of the spinal cord and nerves.
Spinal fusion is nearly always performed to stabilise the vertebrae and prevent the bones collapsing into the disc space. A synthetic spacer is used with artificial bone. Historically, patients’ own bone was taken from their hip or brim of the pelvis which can cause significant pain from the bone donor site. Dr Steel does not use bone from the hip. The use of the synthetic spacers and artificial bone makes this no longer necessary.
A titanium plate is attached to the front of the vertebra to assist stability and promote healing. In young patients, an artificial disc may be used instead of the fusion device. The procedure takes around 2 hours. Patients can go home as early as the day of surgery. Most patients remain in hospital one night. Patients can return to normal day-to-day activities within 1-2 weeks following the surgery. Patients should avoid heavy and repetitive lifting and strenuous activities for 6 weeks. Most patients report immediate alleviation of most of their symptoms following the surgery and can expect to return to all normal sporting activities and exercise after their surgery.