Neck Surgery

Post-operative x-ray of a patient who underwent 2 cervical artificial disk replacements for large disc herniation causing severe neck and arm pain. Patient experience immediate relief of symptoms after surgery

Cervical Arthroplasty

Cervical arthroplasty, also known as artificial disc replacement, is a surgical procedure designed to treat degenerative disc disease in the cervical spine. During this procedure, a damaged or deteriorated intervertebral disc in the neck is replaced with an artificial disc.

The aim of cervical arthroplasty is to maintain motion at the affected spinal segment while alleviating pain and preserving the normal biomechanics of the cervical spine. Unlike traditional cervical fusion, where the disc is removed and the adjacent vertebrae are fused together, arthroplasty allows for continued movement and flexibility.

Candidates for cervical arthroplasty typically have specific criteria, and the procedure is not suitable for everyone. It's essential to consult with your Spine Capital provider to determine the most appropriate treatment based on individual circumstances.

Anterior Cervical Diskectomy and Fusion (ACDF)

Anterior Cervical Discectomy and Fusion (ACDF) is a surgical procedure performed to treat certain neck conditions, such as herniated discs or degenerative disc disease, that may be causing pain, numbness, or weakness. Here's a brief overview:

1. Procedure: In ACDF, a surgeon accesses the cervical spine through the front of the neck. The damaged or problematic disc is removed (discectomy), relieving pressure on nerves or the spinal cord.

2. Fusion: After removing the disc, the adjacent vertebrae are often fused together using a bone graft or a synthetic material. This promotes the fusion of the vertebrae over time, stabilizing the spine. Sometimes, metal plates or screws may be used to provide additional support during the healing process.

3. Pain Relief: ACDF aims to alleviate pain, numbness, and other symptoms associated with cervical spine conditions by decompressing neural structures and restoring stability.

4. Recovery: most patients go home the same day after surgery. Recovery time varies, but patients typically need to limit certain activities for a period to allow for proper healing. You will need to wear a rigid neck brace for 6-8 weeks after surgery when upright and out of bed. Physical therapy may be recommended to aid in rehabilitation.

As with any surgical procedure, potential risks and benefits should be discussed with your Spine Capital professional, and the decision to undergo ACDF should be based on individual circumstances and the severity of the condition.

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Pre-operative MRI and post-operative x ray of a patient who presented with debilitating neck and right arm pain and numbness from C5/6 and C6/7 disc herniations causing foraminal stenosis for which she underwent C5-C7 anterior diskectomy and fusion (ACDF) surgery.

Cervical corpectomy

Cervical corpectomy is a surgical procedure performed on the cervical spine to address conditions such as spinal cord compression, tumors, fractures, or severe degenerative disc disease. Here are key points about cervical corpectomy:

1. Objective: The primary goal is to remove a portion of the vertebral body and adjacent discs to decompress the spinal cord and nerve roots. This creates space and alleviates pressure on neural structures.

2. Surgical Approach: Cervical corpectomy is typically performed through an incision in the front of the neck (anterior approach). This allows direct access to the cervical spine, facilitating the removal of the affected vertebral body and adjacent discs.

3. Indications: Cervical corpectomy may be recommended for conditions such as cervical spondylotic myelopathy, cervical disc herniation, tumors, fractures, or other situations where there is significant compression of the spinal cord.

4. Vertebral Replacement: After removal of the vertebral body and discs, the surgeon may replace the space with a bone graft or a metal cage filled with bone graft material. This promotes spinal stability and facilitates fusion between adjacent vertebrae over time.

5. Instrumentation: In some cases, the surgeon may use metal plates, screws, or other instrumentation to enhance stability during the fusion process.

6. Recovery: Recovery after cervical corpectomy involves a period of rest and rehabilitation. Physical therapy may be recommended to aid in the recovery process and restore neck strength and flexibility.

7. Risks and Complications: As with any surgery, there are potential risks, including infection, bleeding, nerve damage, or issues related to anesthesia. The decision to undergo cervical corpectomy should be made in consultation with a healthcare professional after a thorough evaluation.

Cervical corpectomy is a complex procedure, and the choice to undergo it depends on individual factors, including the specific condition, spinal anatomy, and the surgeon’s recommendations.

Posterior Cervical Decompression and Fusion (PCDF)

Posterior Cervical Decompression and Fusion (PCDF) is a surgical procedure used to address certain spinal conditions affecting the cervical spine. Here’s an overview of the process:

1. Approach: Unlike Anterior Cervical Discectomy and Fusion (ACDF), PCDF is performed from the back of the neck. This surgical approach allows the surgeon to access and decompress the cervical spine from the posterior aspect.

2. Decompression: The procedure involves removing bone or tissue that may be causing compression on the spinal cord or nerves. This can include removing parts of the lamina (laminectomy) or the facet joints.

3. Fusion: Similar to ACDF, the surgeon may use bone grafts or synthetic materials to encourage fusion between the affected vertebrae. Additionally, metal screws and rods, or plates may be used to stabilize the spine during the fusion process.

4. Indications: PCDF is often recommended for conditions such as cervical stenosis, where there is narrowing of the spinal canal, or for the treatment of herniated discs that require decompression from the posterior aspect.

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5. Recovery: The recovery process and postoperative care are similar to other spinal fusion procedures. You will need to wear a rigid neck brace for 12 weeks after surgery to aid in proper healing. Physical therapy and restrictions on certain activities may be part of the recovery plan.

As with any spinal surgery, the decision to undergo PCDF should be based on a thorough evaluation by your Spine Capital provider.

Post-operative x-ray of a patient who underwent a C4-C7 posterior cervical decompressio and fusion (PCDF) for severe multilevel cervical stenosis causing myelopathy as manifested by gait unsteadiness, dexterity issues and numbness in both hands. Patient’s symptoms resolved after her surgery.

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Cervical Laminoplasty

Cervical laminoplasty is a surgical procedure designed to address cervical spinal stenosis, a condition characterized by the narrowing of the spinal canal in the neck. Here are key points about cervical laminoplasty:

1. Objective: The primary goal of cervical laminoplasty is to relieve pressure on the spinal cord and nerves caused by spinal stenosis. Unlike fusion procedures, laminoplasty aims to preserve motion in the cervical spine.

2. Technique: During the procedure, the surgeon creates more space within the spinal canal by making incisions on one side of the lamina (the bony arch on the vertebrae). The lamina is then partially removed or hinged open, creating a “door-like” opening that enlarges the spinal canal.

3. Bone Grafting: To maintain stability and prevent the lamina from collapsing, a bone graft and small titanium plates and screws may be used to support the opened lamina. This helps prevent compression on the spinal cord while preserving flexibility in the neck.

4. Indications: Cervical laminoplasty is often recommended for patients with multilevel cervical stenosis. It can be an alternative to cervical fusion procedures for those who want to retain motion in their neck.

5. Recovery: The recovery process involves postoperative care and rehabilitation, including physical therapy. Patients typically experience less postoperative neck pain compared to fusion procedures, as laminoplasty allows for continued movement.

As with any surgical procedure, the decision to undergo cervical laminoplasty should be based on thorough consultation with your Spine Capital provider who will assess individual circumstances and the severity of the cervical stenosis.

Postoperative x-rays and and artist rendition of C3-C6 laminoplasty in a patient treated forh multilevel cervical stenosis

Minimally Invasive Posterior Cervical Foraminotomy (MI-PCF)

Minimally Invasive Posterior Cervical Foraminotomy (MI-PCF) is a surgical procedure aimed at relieving pressure on spinal nerves in the cervical spine. Here are key aspects of this procedure:

1. Objective: MI-PCF is performed to address conditions such as cervical radiculopathy, where nerve roots in the cervical spine are compressed or irritated. The goal is to decompress the affected nerve by removing a small portion of bone and tissue from the neural foramen (the passageway for nerve roots).

2. Minimally Invasive Approach: Unlike traditional open surgeries, MI-PCF is performed through small incisions using specialized instruments and techniques. This minimizes damage to surrounding tissues, reduces blood loss, and often results in a faster recovery compared to more invasive procedures.

3. Foraminotomy: During the procedure, the surgeon removes a part of the bone and other tissues, such as ligaments, that may be causing compression or narrowing of the neural foramen. This allows for more space around the nerve roots, alleviating symptoms.

4. Indications: MI-PCF is typically recommended for patients with cervical radiculopathy due to conditions like herniated discs, bone spurs, or other factors causing nerve compression in the cervical spine.

5. Advantages: Minimally invasive techniques generally offer benefits such as reduced postoperative pain, shorter hospital stays, and quicker recovery times compared to traditional open surgeries

6. Recovery: Recovery from MI-PCF is often quicker compared to more extensive procedures. This surgery takes less than an hour to perform and most patients go home the same day.Patients may still need a period of rest and rehabilitation, including physical therapy, to optimize their recovery.

As with any surgical procedure, the decision to undergo MI-PCF should be based on a comprehensive evaluation by your Spine Capital provider, taking into account your specific condition and medical history.

Endoscopic cervical foraminotomy

Endoscopic cervical foraminotomy is a minimally invasive surgical procedure designed to address nerve compression in the cervical spine. Here are key points about this procedure:

1. Minimally Invasive Technique: Endoscopic cervical foraminotomy utilizes an endoscope, a thin, flexible tube with a camera and light source, to access the cervical spine through small incisions. This minimizes the need for larger incisions, reducing tissue damage and promoting a quicker recovery.

2. Foraminotomy: The procedure involves removing a portion of the bone or other tissues that may be causing compression or narrowing of the neural foramen. The foramen is the opening through which nerve roots exit the spinal canal.

3. Indications: Endoscopic cervical foraminotomy is typically recommended for conditions such as cervical radiculopathy, where nerve roots are pinched or irritated. Common causes include herniated discs, bone spurs, or other factors leading to nerve compression.

4. Advantages: The minimally invasive nature of endoscopic procedures often results in less postoperative pain, reduced blood loss, shorter hospital stays, and faster recovery compared to traditional open surgeries.

5. Precise Visualization: The endoscope provides a detailed and magnified view of the surgical site, allowing the surgeon to navigate and perform the procedure with precision.

6. Recovery: Patients undergoing endoscopic cervical foraminotomy may experience a quicker recovery compared to more invasive procedures. Postoperative care may include a period of rest and rehabilitation, including physical therapy.

As with any medical procedure, the decision to undergo endoscopic cervical foraminotomy should be based on a thorough evaluation by a healthcare professional, considering the specific condition and medical history of the patient.

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