Our Summary

This research paper is looking at different surgical options for treating a common condition called cervical disc herniation, which is when a disc in the neck slips out of place. They focused on two main types of surgery - one where the disc is removed and replaced with a bone graft or cage (known as anterior cervical decompression and fusion), and another where the disc is replaced with an artificial one (cervical disc arthroplasty).

The first type of surgery is the most popular and has good results, but can lead to neck pain and a hunched posture after the operation. The second type of surgery has become more popular in recent years, as it is thought to reduce the risk of other discs slipping out of place in the future. It has shown encouraging results, but it hasn’t been proven to be better than the first type of surgery. There are also still some unknowns about this type of surgery, such as the risk of bone loss and abnormal bone growth.

In conclusion, the research suggests that the first type of surgery, where the disc is removed and replaced with a bone graft or cage, remains the best option for treating cervical disc herniation.

FAQs

  1. What are the different surgical options for treating cervical disc herniation?
  2. How does cervical disc arthroplasty compare to anterior cervical decompression and fusion?
  3. What are the potential concerns or limitations with cervical disc arthroplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal surgery is to follow post-operative instructions carefully, including any physical therapy or rehabilitation exercises prescribed. This can help improve recovery and prevent complications. Additionally, maintaining a healthy lifestyle, including regular exercise and proper nutrition, can also support the healing process after spinal surgery.

Suitable For

Patients who are typically recommended spinal surgery for cervical disc herniation include those who have not responded to conservative treatments such as physical therapy, medication, and injections. Surgery may also be recommended for patients with severe or progressive neurological deficits, such as weakness, numbness, or pain that radiates down the arm. Additionally, patients with cervical disc herniation causing spinal cord compression or who have significant cervical instability may also be candidates for spinal surgery.

Timeline

Before spinal surgery:

  1. Patient experiences symptoms of cervical disc herniation such as neck pain, arm pain, numbness, and weakness.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis.
  3. Patient consults with a spine surgeon to discuss treatment options.
  4. Patient may undergo conservative treatments such as physical therapy, medications, and injections before considering surgery.

After spinal surgery:

  1. Patient undergoes pre-operative tests and evaluations to ensure they are a good candidate for surgery.
  2. Patient undergoes spinal surgery, which can be anterior cervical decompression and fusion, cervical disc arthroplasty, or other procedures.
  3. Patient is monitored closely in the immediate post-operative period for any complications.
  4. Patient undergoes physical therapy and rehabilitation to regain strength and mobility.
  5. Patient follows up with the surgeon for post-operative appointments to monitor progress and address any concerns.
  6. Patient may experience improvements in symptoms such as reduced pain and improved function following surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the specific spinal surgery procedure being recommended?
  2. What is the expected recovery time and rehabilitation process after the surgery?
  3. Are there any alternative treatment options available for my condition?
  4. How successful is this particular spinal surgery procedure in relieving symptoms and improving quality of life?
  5. What is the long-term outlook for patients who undergo this type of surgery?
  6. Will I need physical therapy or other ongoing treatments after the surgery?
  7. How experienced is the surgeon in performing this specific type of spinal surgery?
  8. Are there any specific lifestyle changes or precautions I should take after the surgery to ensure a successful recovery?
  9. Will I need any additional imaging tests or follow-up appointments after the surgery?
  10. What are the expected costs associated with the surgery, including any potential insurance coverage or payment options?

Reference

Authors: Mazas S, Benzakour A, Castelain JE, Damade C, Ghailane S, Gille O. Journal: Int Orthop. 2019 Apr;43(4):761-766. doi: 10.1007/s00264-018-4221-3. Epub 2018 Nov 8. PMID: 30411247