If the operation is more extensive, it may require a slanted or longer incision. After the soft tissues of the neck are separated, the intervertebral disc and bone spurs are removed and the spinal cord and nerve roots are decompressed.
What You Need to Know About Cervical Spine Disorders
The space left between the vertebrae is filled with a small piece of bone or device through spinal fusion. In time, the vertebrae will fuse or join together across that level. The corpectomy is often done for cervical stenosis with spinal cord compression caused by bone spur formations that cannot be removed with a discectomy alone.
In this procedure, the neurosurgeon removes a part or all of the vertebral body to relieve pressure on the spinal cord. One or more vertebral bodies may be removed, including the adjoining discs for multilevel disease. The space between the vertebrae is filled using a small piece of bone or device through spinal fusion. Because more bone is removed, the recovery process for the fusion to heal and the neck to become stable is generally longer than with anterior cervical discectomy. The surgeon may choose to support the anterior construct with a posterior instrumentation and fusion, depending on the amount of spinal reconstruction required.
Cervical Spondylosis and Other Disorders of the Cervical Spine
Watch Procedure: Anterior Cervical Corpectomy. This procedure is performed through a small vertical incision in the posterior back of your neck, generally in the middle. This approach may be considered for a large soft disc herniation that is located on the side of the spinal cord. A high speed burr is used to remove some of the facet joint, and the nerve root is identified under the facet joint.
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The nerve root needs to be gently moved aside to free up and remove the disc herniation. This procedure requires a small incision in the middle of the back neck to remove the lamina. The foramen , the passageway in the vertebrae through which the spinal nerve roots travel, may also be enlarged to allow the nerves to pass through. Depending on the severity of the degeneration and amount of reconstruction required, the surgeon may determine that a posterior spinal fusion is needed in addition to the laminectomy to maintain proper spinal stability and alignment.
This may reduce the risk of requiring future interventions at those levels. Although complications are fairly rare, as with any surgery, the following risks may be associated with cervical spine surgery:. The benefits of surgery should always be weighed carefully against its risks. Although a large percentage of cervical spine patients report significant pain relief after surgery, there is no guarantee that surgery will help every individual. The doctor will give specific instructions post-surgery and usually prescribe pain medication. The doctor will help determine when the patient can resume normal activities such as returning to work, driving and exercising depending on the type of surgery.
Some patients may benefit from supervised rehabilitation or physical therapy after surgery. Discomfort is expected while the patient gradually returns to normal activity, but pain is a warning signal that he or she might need to slow down. Postoperatively, the neurosurgeon may elect to obtain x-rays of the spine to assess alignment, status of the instrumentation and fusion and generally monitor levels of the spine adjacent to the surgery. There is also loss of the normal spinal alignment and cervical lordosis due to the degeneration. Muscles in one or both arms may become weak and waste away, making the arms weak.
Doctors suspect cervical spondylosis based on symptoms, especially in older people or in people who have osteoarthritis. MRI provides much more information because it shows the spinal cord and roots. CT does not show them.
However, both procedures show where the spinal canal is narrowed, how compressed the spinal cord is, and which spinal nerve roots may be affected. Without treatment, symptoms of spinal cord dysfunction due to cervical spondylosis sometimes lessen or remain the same, but they may worsen.
Initially, especially if only nerve roots are compressed, a soft neck collar to support the neck and nonsteroidal anti-inflammatory drugs NSAIDs such as ibuprofen may provide relief. If they do not, surgery may be needed. If the spinal cord is compressed, surgery is usually needed.
An incision may be made through the front or back of the neck. Then, part of the affected vertebrae is removed to make more room for the spinal cord—a procedure called laminectomy.
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Bone spurs, if present, are removed, and the spine may be stabilized by fusing the vertebrae together. As a rule, surgery does not reverse the existing nerve damage, but it prevents additional nerve damage. The earlier the surgery, the better the outcome. Because the spine may be unstable after surgery, people may need to wear a rigid brace to hold the head still while healing occurs. If muscle spasms occur, baclofen , a muscle relaxant, helps relieve them.
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Signs and symptoms
From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. The Manual was first published in as a service to the community. Learn more about our commitment to Global Medical Knowledge. It's vital that you're comfortable with your treatment decision and have confidence in your doctor.
For these reasons, a second opinion with another specialist can help you make smart treatment decisions. Symptoms Symptoms of Cervical Spine Disorders Because a cervical spine injury or condition occurs near your neck cervical , symptoms can affect both your arms and legs. Other symptoms may include: Breathing difficulties from paralysis of the breathing muscles Loss of normal bowel and bladder control that may include constipation, incontinence, bladder spasms Numbness Sensory changes Spasticity overstimulated muscle tissue Pain Weakness, paralysis.