What to Expect During and After a Cervical Spine Surgery
Cervical spine surgery is a procedure that corrects the movement of the neck and alleviate nerve compression. The prospect of surgery can be downright intimidating. If you are having one in the future, continue reading to know what to expect.
When is it necessary?
The cervical spine begins at the base of the skull, made up of the first seven vertebrae which are abbreviated as C1, C2, C3, C4, C5, C6 and C7. Compared to the other spinal vertebrae, the cervical bones are smaller in size. The cervical spine functions to support the skull, protect the spinal cord, and allow a diverse range of head movement.
The cervical spine is stabilized by a system of ligaments tendons and muscles. Ligaments prevent excessive movement, while the tendons and muscles provide spinal stability, balance and movement ability. Intervertebral discs (cushion pads) between the vertebrae function as shock absorption, and allows slight movement between the vertebrae.
Surgery becomes necessary when a degenerative disease or deformity occurs. With degenerative disease, the intervertebral discs shrink, which causes a wearing down of the disc. The wearing down may lead to disc herniation, which is a bulging of the discs. Degeneration results in compression to the nerves which causes pain, numbness, tingling, and weakness.
Individuals with cervical deformity, such as hyperlordosis or swan neck may have cervical spine surgery to help straighten and stabilize the spine. Cervical deformities leave the neck vulnerable to injury, and some injuries may lead to dislocation or fracture of the cervical vertebrae. Surgery in this case is beneficial for relieving pressure on the spinal cord.
The specific cervical spine procedure depends on what is causing the problem. Generally, surgeons use two techniques: decompression and stabilization. With cervical spine decompression surgery, the tissue that is impinging on a nerve structure is removed. A decompression procedure may be performed from the front (anterior cervical spine surgery) or the back (posterior surgery). The types of decompression procedures are:
- Foraminotomy, which creates a bigger space in the vertebra
- Laminotomy, creates a whole in the lamina of the vertebra to make more space for the spinal cord
- Facetectomy, removes the facet joint to relieve pressure on a nerve
- Laminoplasty, reconstructs the lamina to create more space for the spinal cord
- Discectomy, removes all or part of the herniated disc
- Corpectomy, the entire vertebral body is removed to gain access to the disc.
Stabilization surgery limits movement between the vertebrae. This becomes necessary when there is abnormal movement in the spinal column, which potentially leads to nerve injury. Stabilization surgery is usually necessary after a discectomy or corpectomy. The two stabilization techniques include:
- Fusion, which bonds the bones together via a bone graft; stop the motion between the vertebrae
- Instrumentation, fusion is supplemented by devices such as plates, screws, wires, cables, and rods.
A new medical technology known as artificial disc replacement is another option for cervical spine surgery. Instead of fusing the spine together after surgery, a disc is replaced so the patient can retain normal neck movement.
Depending on the severity of the condition, a patient may qualify to undergo minimally invasive cervical spine surgery. In this surgery, a small incision is made with the help of an endoscope to disrupt the muscles minimally. Compared to normal cervical spine surgery, the pain and recovery time is less. This surgery relieves patients from scoliosis, herniated discs, and several other painful conditions.
Any type of surgery is performed while a patient is under general anesthesia.
The hospital stay following cervical spine disc surgery may may up to seven days. Activity is an important part of recovery, a patient is encouraged to walk the first or second day after surgery. This is to reduce the risks of blood clots.
Normally a surgeon orders a collar/neck brace, and gives the patient specific instructions about its use.
Full recovery takes about 5 weeks. There are no restrictions for walking or stair climbing during the recovery period. For the first six weeks at home, objects heavier than 10 pounds should not be lifted, especially over the head. Any sleep position that is comfortable for the patient is acceptable as long as the neck brace is worn properly. Driving is prohibited during recovery, but short rides as a passenger is allowed.
Prescription medications are also provided for when the patient leaves the hospital. In the event of a bone graft procedure, non-steroidal anti-inflammatory medications are prohibited for six weeks following surgery, as these medications may interfere with the healing. As an alternative, a patient may use hot or cold moist compresses over the site or shoulders.
Incisions may be washed with mild soap and water, but tub baths, swimming pools, or any water immersion should be avoided for six weeks after surgery.
Complications and risks
As with any type of surgical procedure, there are some risks associated with cervical spine surgery. Common risks include:
- Adverse reaction to the anesthesia
- Potential of further injury to the spinal cord and the surrounding nerves
- Improper healing of spinal fusion
- Rejection of bone grafts.
It is important for the patient to understand the risks as well as the potential benefits of having the cervical surgery, making it possible to prepare adequately for the recovery period.
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