Anterior Cervical Discectomy Surgery
An anterior cervical discectomy is the most common surgery used to correct damaged discs (shock-absorbing cushions between the vertebrae of the spinal column) in the neck area of the spine. Your spine surgeon reaches your cervical spine through a small incision in the front (anterior) of your neck. After the soft tissues of the neck are separated, the damaged intervertebral disc(s) and bone spurs are removed. The goal for anterior cervical discectomy surgery is to remove the ruptured disc(s) and any remaining fragments that are compressing the spinal cord or the nerve roots that branch out from it.
Anterior cervical discectomy surgery is commonly performed in conjunction with cervical fusion surgery, a procedure that replaces the damaged disc with bone graft material in order to fuse the surrounding vertebrae together. The fusion allows normal height and stability to be maintained in the spinal structure. Since a bone graft can take several months to fuse together with the adjacent vertebrae, the surgeon may secure and support the bone graft with a metal plate, rod and screws (known as instrumentation) fastened to the spine and vertebrae surrounding the bone graft.
Conditions Treated with Anterior Cervical Discectomy
- Degenerative disc disease – Through normal wear and tear the affected disc dries out and shrinks, losing it flexibility and cushioning properties. Bone spurs form and the facet joints become inflamed. All of these changes eventually lead to a ruptured disc in the spine.
- Cervical spinal stenosis – This condition consists of a narrowing of the spinal canal in the neck. This narrowing causes the nearby discs to flatten and bulge, and eventually rupture over time.
Herniated Discs and the Spinal Cord
The vertebrae in your spine protect the nerve bundles which lead from your brain all the way down the spinal cord. The nerve roots branch out from your spinal cord by traveling between the vertebrae to reach other parts of your body. The vertebrae are separated and protected by discs which act as flexible cushions. The discs give the spine mobility while preventing the vertebrae from rubbing against each other.
When a disc is damaged or begins to degenerate, it collapses and dries out which begins a series of events that happen like dominos falling. The space between the vertebrae decreases, resulting in actual loss of body height. Additionally, the neural foramina (openings) around the spinal nerves narrow and cause compression of the nerves. The ligaments of the spine become slack and put pressure on the spinal cord.
As the disc collapses, the outer layer of the disc (annulus fibrosis) begins forming cracks. The nucleus pulposus inside the disc begins to seep out through the cracks and compresses the ligaments, nerves and surrounding vertebral structure. This condition is referred to as a herniated or ruptured disc. When the disc fragments put pressure on the surrounding structure of the spine it can cause tremendous pain, weakness and spinal instability. Pressure on the spinal cord, known as myelopathy, can cause bowel and bladder problems, irregularities in the way you walk and can even disrupt the fine motor skills of your hands.
The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Spine Services in New York performs anterior cervical discectomy surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the spine.
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