Titanium implant fixed to cervical spine

Patient positioned for surgery

Degenerative changes in the cervical spine can lead to bulging of the intervertebral disc and formation of bone spurs that compromise the available space for the spinal cord and nerves. These pathological changes may result in injury to the exiting nerves or the spinal cord. Nonoperative measures may be attempted; however, surgical intervention is typically the treatment of choice, particularly if the spinal cord is at risk. The operative procedure — known as an anterior cervical discectomy and fusion/fixation — is intended to decompress the neural elements and re-stabilize the cervical spine.

Surgical Procedure
The procedure is performed under general anesthesia. An incision is created in a natural skin crease on the front of the neck with minimal scar formation. The degree of soft tissue disruption is minimized since access to the front of the spine is achieved along natural tissue planes that easily separate. Once the anterior spine is identified, the disc is removed (the discectomy) along with any associated bone spurs. When the neural elements are decompressed, the disc that has been removed is replaced with a bone plug or plastic spacer and secured with a titanium plate and screws (the fusion/fixation). The fusion/fixation is performed to restore the stability to the front of the spine and maintain a more normal spinal alignment. The incision is then closed with absorbable sutures and dressed with a small gauze bandage.

In some cases, you may have the option of getting an artificial disk replacement instead of a fusion. Our surgeons are also involved in cutting edge clinical trials intended to test the efficacy of disk replacement.

Course of Treatment
Patients are usually discharged on the day following surgery. Post-operative pain is controlled with oral medication. Following surgery, patients are encouraged to increase their activity as they are able to tolerate but to refrain from strenuous exercise until cleared by their treating physician. Patients are not required to wear a cervical collar since the metallic implant provides immediate stability. Serial X-rays are obtained during the follow-up period to monitor the progress of bone healing. Physical therapy focusing on the neck is not initiated until the initial follow-up visit, at four to six weeks after surgery.