The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs. The vertebrae and discs form a column from your head to your pelvis providing symmetry and support to the body. The uppermost segment of the back bone is the cervical region, consisting of 7 small vertebrae that form the neck.
Herniated cervical disc is a neck condition caused by a tear in one of the intervertebral discs causing the disc contents to bulge out. The bulging section of the disc places pressure on nerve roots or the spinal cord causing radiculopathy. Radiculopathy is a medical term used to describe the neurological deficits that can occur from pressure on the spinal cord, such as arm or finger weakness, numbness or pain.
Anterior Cervical Discectomy is a surgical procedure to alleviate severe pain and disability resulting from the compression of spinal nerves in the neck area from a herniated disc. This surgery is usually recommended for patients whose symptoms have not been relieved by other treatments such as rest, medication, physical therapy, and pain blocking injections. The surgery is performed through an incision in the front of the neck and involves removing the bulging disc contents and any bony segments placing pressure on neural structures.
Your surgeon may recommend incorporating a fusion during the surgery. This involves the placement of a bone graft between the two vertebrae where the disc is removed to fuse (join) the two vertebrae together. Bone grafts can be obtained from the following sources:
- Allograft: This is bone from a bone bank that has been donated.
- Autograft: This is bone taken from the patient’s hip requiring another incision to the body.
- Combination of both allograft and autograft
- Bone graft substitute
The fusion process varies in each patient and can take anywhere from 6-9 months or longer.
Other alternatives are available to treat herniated cervical discs such as artificial discs that are placed between the vertebrae instead of a bone graft. The goal of inserting artificial discs is to maintain flexibility and motion that are lost when fusion is performed.
Talk to your surgeon about the best options for your condition.
Disc Replacement and Nonfusion Technologies
Herniated cervical disc is a neck condition caused by a tear in one of the intervertebral discs causing the disc contents to bulge out. The bulging section of the disc places pressure on nerve roots (nerve root compression) or the spinal cord causing radiculopathy. Radiculopathy is a medical term used to describe the neurological deficits that can occur from pressure on the nerves and spinal cord, such as arm or finger weakness, numbness or pain.
Other conditions that can cause nerve root compression and radiculopathy include:
- Degenerative Disc Disease: A condition caused by wear and tear on the discs between the vertebrae causing them to lose their cushioning ability.
- Spinal Stenosis: Narrowing of the spinal canal as we age, most commonly due to degenerative arthritis.
- Degenerative Spondylolisthesis: This condition is degeneration (wear and tear) of the vertebral components, usually occurring after age 50, causing slippage of a vertebra onto another, leading to spinal stenosis, a narrowing of the spinal canal.
When conservative treatment measures such as rest, medication, physical therapy, and pain blocking injections are ineffective, your surgeon may recommend cervical spine surgery.
The most common spine surgery to relieve symptoms of nerve root compression involves removing the disc and fusing the two vertebrae above and below it with a bone graft. A newer treatment option is now available to replace the herniated disc with an artificial disc. Artificial discs are used in place of a bone fusion to preserve neck movement and flexibility.
Benefits of artificial discs over fusion surgery include:
- No need for instrumentation (plates and screws)
- Shorter healing time with no waiting for fusion to occur
- No bone harvesting from hip which requires an incision, pain, and risks.
- Reduced risk of degeneration of adjacent vertebrae
- Maintain normal neck movement
- No post-operative neck bracing needed
As with any surgery, there are risks involved. It is important you discuss the benefits and risks to make an informed decision on moving forward with the surgery. Talk to your surgeon about any questions you may have.