Quick Facts
Possible Symptoms
- Arm and/or hand pain, numbness, and/or weakness
- Neck and head pain, especially with movement
- Difficulty with balance
Typical X-Ray Findings
- Herniated disk compressing spinal cord and/or nerve roots (MRI, CT myelogram).
- Spondylolisthesis or slippage of one vertebra on the other.
- Instability with flexion and extension (X rays)
Average Procedure Time
- One level: 1.5 hours
- Two levels: 2.5 hours
- Three levels: 3.5 hours
Average Recovery Time
- Home in 1-2 days
- Off work 2-8 weeks, depending on duties
Postperative Limitations
- Cervical collar for > 2 levels (8 weeks)
- No bending, twisting, lifting, or strenuous exercises (8 weeks)
- No driving while on narcotics
The Procedure
A discectomy is the removal of all or part of a degenerated disk that is causing nerve or spinal cord compression. Though cervical discectomies used to be performed from a posterior approach, that is, from behind, now they are usually performed from an anterior approach. This is because there are few organs in front of the cervical spine, and it can be difficult to remove a disk from a posterior approach with the spinal cord in the way.
Since almost all of the disk is removed in an anterior cervical discectomy, bone graft within a cage to replace the disk and to encourage bony growth between the vertebrae above and below is commonly placed along with a plate to secure the entire structure. Most spinal surgeons agree that this procedure, called an anterior cervical discectomy and fusion, provides for a faster return to work and a better long term outcome over an anterior cervical discectomy alone.
The procedure involves making a small incision on the front of the neck, and removing most of the cervical disk from the front. After the spinal cord and nerve roots are well decompressed, an interbody cage filled with bone is placed to preserve the disk height and promote fusion. A plate and screws are then placed to stabilize the construct.