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Cervical Discetomy & Fusion

If you pinch a nerve in the neck it can lead to pain down the arm. This is similar to the pain down the leg from a pinched nerve in the lower back which is called sciatica.

Often neck and arm pain will improve over six weeks or so and well directed physical therapy or a targeted neck injection can be very helpful.

If your painful arm symptoms persist then neck surgery can be very successful.

Uses

Cervical discectomy and fusion is most commonly used to remove a slipped disc or bony spur which is pressing on a nerve in the neck.

Procedure

Most neck surgery is best carried out through the front (anterior) of the neck because this avoids damage to the spine muscles at the back of the neck.

We make a small horizontal skin incision (about 3 cms) and gently dissect to reach the spine without damaging any of the tissues.

Unlike with surgery in the lower back it is normally necessary to remove all of the disc to reach the trapped nerve.

The disc herniation or bony spur is then nibbled away freeing the nerve.

Now we have a choice – fusion or disc replacement?

When performing a fusion we wedge a block of synthetic material (called a cage) into the empty disc space. This has the advantage of avoiding taking bone from elsewhere.

The skin is then closed over a drain which is there to collect any blood.

The whole procedure takes just over one hour.

Benefits

This operation has an excellent chance of being successful regardless of whether we perform a fusion or disc replacement.

Results at The UK Spine Centre are excellent with a 90% chance that your arm pain will be better. Neck pain like back pain can be less predictable and reflects the general condition of the neck.

There is a 5-10% chance that you are improved but not completely better. This may be because the nerve remains damaged and bruised from being compressed.

Risks

Surgery on the neck sounds alarming however in our centre is performed routinely and safely with a low risk of complications.

There is a 1-2% chance of having a complication which includes a nerve injury, spinal fluid leak, infection, implant migration, hoarseness, swallowing problems, bleeding. Spinal cord injury or paralysis is thankfully exceptionally rare.

About 5% of individuals (one in twenty) may have ongoing pain despite the nerve being successfully decompressed.

Recovery

In our experience patients recover very quickly from anterior cervical surgery and there is no difference in recovery between performing an anterior fusion or disc replacement.

You will wake up with a small drain in the neck which prevents any blood collecting. We remove this simply within 24 hours.

You will be up and about within a few hours of the procedure and home the same day. You will not require a neck collar.

We use a dissolvable suture which patients prefer.

Simple painkillers may be helpful in the first week or so but usually arm pain is better very quickly. Pins and needles and numbness may take longer to improve as the nerve heals.

Swallowing may feel a bit ‘sticky’ due to bruising, but this usually settles within a few weeks.

You can build up your walking and aerobic exercise each day.

You can return to work within a few weeks or when you feel ready.
We will see you back in clinic six weeks after your operation and then 3 months later.

Patients can return to non-contact competitive sport from 3 months, and one year for contact sports such as rugby.

Our team will support you before and after surgery and your specialist remains available to you at any time.

Further Reading

Please see our Patient Stories which describe real patients, their problems, diagnosis and successful treatment under our care at The UK Spine Centre.

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