Spine surgery

Cervical discectomy

This article provides general information about cervical discectomy (cervical microdiscectomy) surgery. This information is not a substitute for advice from Dr Reddy and does not account for your individual health, diagnosis or treatment plan.

 

Cervical discectomy or microdiscectomy, also called an anterior decompression, is a surgical procedure that removes the damaged or herniated part of a disc in the neck to release the pressure this puts on the spinal nerves and spinal cord.

Spinal discs are rubbery round-shaped discs that sit between the stacks of vertebrae (bone) that make up the spine to support them. However, the outer layer of a disc may weaken over time, which may lead to damage. Discs can also become damaged through injury. Damage may include the soft, inner part of the disc bulging out – a condition known as disc herniation. This bulging can put pressure on the spinal cord, which travels down the centre of the spine, and the spinal nerves, which travel from the spinal cord through small holes in the spine to different parts of your body.

Pressure on your spinal nerves in the neck can cause pain, tingling, pins and needles, numbness and weakness in the arms and hands, neck and shoulder pain, and headache. Pressure on the spinal cord in this area may lead to walking problems, bowel and bladder problems, sensory changes in the torso, and impotence in males.

Why might someone need a cervical discectomy?

A person may need a cervical discectomy if their symptoms are severe and do not improve with nonsurgical treatment.

A cervical discectomy may be suitable for people with the following:

  • persistent symptoms of a herniated disc that impact on their ability to function, despite nonsurgical treatment
  • significant weakness in the arm or hand
  • arm pain that is worse than neck pain
  • difficulty walking
  • sensation changes in the torso area
  • bowel or bladder problems

Not everyone with a herniated disc should have a cervical discectomy, including those with no symptoms or symptoms that ease with physical therapy or anti-inflammatory medicine.

It’s important to discuss with Dr Reddy to understand if a cervical discectomy is an appropriate treatment for your condition.

How is a cervical discectomy done?

After the person is put to sleep with general anaesthetic, the surgeon makes a small incision (surgical cut) to the skin over the affected part of the spine to reach the herniated disc. They then use small instruments and a microscope to remove the part of the disc that has been compressing the spinal nerves. The surgeon may also remove other compressive structures, such as osteophytes (bony spurs or bone overgrowth) and any loose disc fragments.

If the surgeon needs to remove the whole disc, they may fill the space with bone (a spinal fusion) or an artificial disc (cervical disc replacement) and secure it into place.

What are the benefits of a cervical discectomy?

A cervical discectomy gives most people relief of their arm pain and some people relief of their neck pain. However, it may take time to feel better.

People’s muscles usually get stronger after surgery but may not return to full strength. It can take months for numbness to reduce.

The amount of improvement usually corresponds with how long you have had pain, and whether there has been spinal cord or nerve damage.

What are the risks of a cervical discectomy?

A cervical discectomy is a relatively safe and simple procedure. However, all surgical procedures carry risk.

Some potential risks of this procedure include but are not limited to:

  • bleeding, infection, blood clots, and reaction to anaesthesia, as with any surgical procedure
  • symptoms persisting despite surgery
  • new back or leg pain after surgery
  • cerebrospinal fluid leak – the membrane covering the spinal cord or dura mater may be inadvertently punctured, leading to leakage of fluid and requiring repair during the operation
  • disc herniation happening again – this is because of the small chance that material may still come out of the disc, which may require another operation, depending on the nature and severity
  • instability

Very rare risks of a microdiscectomy include:

  • damage to the spinal nerve roots, resulting in worsened pain, weakness or numbness
  • paralysis due to nerve or spinal cord damage
  • incontinence (bowel and bladder problems)
  • impotence in males (erectile dysfunction)

Your surgeon will discuss the risks with you in more detail and answer any questions you may have.

How should I decide to have a cervical discectomy?

To decide whether to have a cervical discectomy, it is important to discuss your medical condition and the procedure with your doctor, and carefully consider the benefits, risks and limitations.

There may be risks with not having surgery to stop the pressure on your spinal nerves. In serious cases, not having surgery may include more damage, pain, numbness, paralysis or loss of bladder and bowel control.

If you decide to have surgery, you will need to sign a consent form. Please read this carefully before signing it. If you have any questions, ask Dr Reddy.

How do I prepare for a cervical discectomy?

Make sure you tell Dr Reddy all the medicine you take, including over-the-counter, prescription and herbal medication, as well as vitamins and supplements, so he can advise if you need to stop any of these before surgery.

You may also need to stop eating and drinking in the hours before your operation.

If you stay at hospital overnight, make sure you bring any essential items with you.

Speak with Dr Reddy to learn exactly what you need to do before your procedure.

What happens after surgery?

After surgery, you will be taken to a recovery room where your healthcare team will monitor your health. Most people will be able to leave hospital on the same day, but others may need to stay overnight, depending on their circumstances.

If your job doesn’t involve much physical activity, you may be able to return to work after 2 to 6 weeks. If you have a job that includes heavy labour, you may not be able to return to work for about 6 to 8 weeks.

To maintain a healthy spine, it’s a good idea to keep a healthy weight, eat healthily, do gentle exercise regularly and avoid lots of bending, twisting or lifting.

 

Please only refer to this information in consultation with Dr Reddy. If you have any questions, speak with Dr Reddy.