The Purpose of this Information:
This information is being provided to you in order to prepare
you to make decisions about your own health care. If you should ultimately
decide that surgery is the best treatment option for you, this section
will help you understand what happens during an anterior cervical discectomy
and will help you prepare for your role in the healing and recovery
process. Read it thoroughly and answer the questions before making
your final decision about your treatment options.
The Health Care Team's
- evaluate your condition;
- establish a diagnosis;
- present the various
- offer a specific treatment
you with the information you need to make a decision; and
then support you in the decision you make.
The Patient's Responsibilities
You are the only one who can decide to have surgery. It is important
that you take ownership of this decision, recognizing the limitations
your particular physical condition places on the potential success
of each of the treatment options.
If you choose to have surgery, your physical condition and your
mental attitude will determine your body's ability to heal. You
must approach your surgery with confidence, a positive attitude,
and a thorough understanding of the anticipated outcome. You should
have realistic goals - and work steadily to achieve those goals.
The decision to have or not to have surgery includes weighing
the risks and benefits involved. You will make the final decision,
so ask questions about anything you do not understand.
Since medical care is tailored to each person's needs and differences,
not all information presented here will apply to the patient's
treatment or its outcome. Seek the advice of your physician and
other members of the health care team for specific information
about the patient's medical condition.
Anatomy of the Spine
The spinal column, or backbone, consists of 33 bones (vertebrae)
and can be divided into five segments (Fig. 1A). The uppermost 24 vertebrae
are separated from one another by fibrous cartilage pads, called intervertebral
discs (Fig. 1B), which allow the spine to bend and act as shock absorbers
during activity. In the lowest part of the spine, the vertebrae are
naturally fused to form the sacrum and the coccyx (tail bone).
the back of each block-like vertebral body is an arch of bone that
helps to form the large, vertical spinal canal, which surrounds
the spinal cord and nerve bundles (Fig. 1C, below). A fluid-filled
protective membrane, the dura, covers the contents of the
spinal canal from where the cord begins at the base of the brain
to where it ends (in a bundle of nerve fibers known as the cauda
|A pair of spinal nerves
branches at each vertebral level (one to the left and one to the
right), providing sensation and movement to all parts of the body.
Three large bone processes arise from the vertebrae's arch-one
to each side (transverse) and one straight toward the back of the
body (spinous). Strong ligaments and muscles attached to the vertebrae
both support the spine and further protect the delicate spinal
cord and nerves inside.
|What is it?
Anterior cervical discectomy is an operation performed on the upper spine to
relieve pressure on one or more nerve roots, or on the spinal cord. The procedure
is explained by the words anterior (front), cervical (neck), and discectomy
(cutting out the disc).
Why is it done?
Neck and arm pain, among other symptoms, may occur
when an intervertebral disc herniates. This happens, either suddenly
with injury or slowly over time, when some of the disc's jelly-like
center (the nucleus pulposus) bulges or ruptures through its
tough, fibrous outer ring (the annulus fibrosus) and presses
on a nerve (Fig 1C, above).
When a disc ruptures in
the cervical spine, it puts pressure on one or more nerve roots
(often called nerve root compression) or on the spinal cord, as
seen in (Figure 2). This pressure causes symptoms in the neck,
arms, and even legs. Further pressure may be caused by rough edges
of bone, called bone
spurs, that naturally build up around some herniated discs.
In this operation, the cervical spine is reached through a small
incision in the front of your neck. After the soft tissues of the
neck are separated, the intervertebral disc and bone spurs are
removed. The space left between the vertebrae may be left open
or filled with a small piece of bone. In time the vertebrae may
fuse, or join together.
If used, the pre-formed bone graft
may be obtained from a bone bank. It will not be rejected by your
body, because it is avascular (contains no blood cells). In some
circumstances, or if your surgeon prefers, the bone graft might
instead be removed from your own hip through a second incision.
Successful recovery from anterior cervical discectomy requires that you approach
the operation and recovery with confidence based on a thorough understanding
of each process. Your surgeon has the training and expertise to correct physical
defects by performing the operation; he and the rest of the health care team
will support your body's efforts to heal its damaged tissues. Full recovery will
also depend on you having a strong, positive attitude, setting small, realistic
goals for improvement, and working steadily to accomplish each goal.