Minimally Invasive Back & Spine Surgery
Minimally Invasive Back & Spine Surgery
The cervical spine is made up of seven vertebrae stacked vertically in the neck. Between each vertebra lies an intervertebral disc that functions as a cushion and allows for neck movement. Each disc has a tough outer ring called the annulus fibrosus and a gel-like inner center known as the nucleus pulposus.
These discs serve multiple functions. They act as shock absorbers during everyday activities such as walking, turning, and lifting. They also provide flexibility and help maintain proper spacing and alignment of the vertebrae. When healthy, cervical discs support a full range of neck motion without pain or stiffness.
Herniated Disc: A cervical herniated disc occurs when the inner gel-like core of a disc pushes through its outer layer, often due to wear and tear or sudden injury. This can put pressure on nearby nerves, causing neck pain, numbness, tingling, or weakness in the arms and hands.
Degenerative Disc Disease: As we age, the discs between the vertebrae can naturally wear down, lose hydration, and become less effective at absorbing shock. In the cervical spine, this can lead to chronic neck stiffness, nerve compression, and radiating arm pain, often referred to as degenerative disc disease.
Cervical Stenosis: Cervical stenosis is the narrowing of the spinal canal in the neck, which can compress the spinal cord or nerve roots. This condition may develop slowly over time and lead to symptoms like neck pain, balance problems, clumsiness, or even changes in bowel or bladder control in more severe cases.
Conservative Non-Surgical Care Initial treatment focuses on reducing inflammation and relieving nerve pressure. This may include non-steroidal anti-inflammatory drugs, physical therapy, and activity modification. Therapists may recommend posture correction, cervical traction, and exercises to strengthen neck and shoulder muscles. In some cases, corticosteroid injections may be administered near the affected nerve root to reduce inflammation and improve comfort. Most patients experience gradual symptom relief over several weeks to months.
Anterior Cervical Artificial Disc Replacement (ADR)
When conservative treatments such as physical therapy, medication, or injections no longer relieve neck pain, numbness, or weakness caused by a damaged cervical disc, surgery may be recommended. One modern surgical option is anterior cervical artificial disc replacement (ADR), an alternative to spinal fusion that aims to maintain natural movement in the neck. During this procedure, the surgeon makes a small incision in the front of the neck to access the cervical spine. The damaged or herniated disc is carefully removed to take pressure off the spinal cord or nearby nerves. Instead of fusing the bones together, an artificial disc is inserted in the space between the vertebrae. This device is designed to replicate the natural motion of a healthy disc, allowing for continued flexibility and movement at that spinal level. Artificial disc replacement may reduce the risk of adjacent segment disease — a condition where nearby discs break down faster after fusion surgery. By preserving motion, ADR can also help patients return to normal activities more quickly. The primary goals of cervical disc replacement are to:
This minimally invasive procedure is most commonly recommended for patients with one or two levels of disc disease and no significant spinal instability.
Though cADR is a safe and effective procedure, as with any surgery, there are potential risks:
Pain relief in the arm and hand is often immediate. If nerve irritation has existed for a long time, improvement may take longer. As nerves heal, some patients report tingling or a warm sensation in the affected areas.
Muscle strength typically returns before numbness resolves. Numbness that existed for several months or longer before surgery may become permanent.
Incision pain usually decreases significantly within two to three weeks. Some discomfort with prolonged sitting or driving is normal. Patients are advised not to drive for about three weeks or until cleared by their physician.
During your first post-operative visit, the incision will be evaluated and any necessary stitches will be removed.
Pain medications may cause constipation. To minimize this, increase your intake of water, fruits, vegetables, and whole grains. Regular walking can also help.
Pain medications may cause constipation. To minimize this, increase your intake of water, fruits, vegetables, and whole grains. Regular walking can also help.
For refills, request them through your pharmacy and allow up to forty-eight hours. Refills will not be processed on weekends or after office hours, so plan ahead.
Do not soak your wound. No bathtub, swimming, or hot tub, etc. until you have received permission from your physician.
To shower: simply remove the outer gauze bandage and shower as usual. Blot the incision dry, and then cover it with a clean, dry bandage.
Avoid twisting, bending, or forcing neck movement in any direction. Gentle neck mobility is encouraged, but only within comfort limits. Driving should not resume until your physician has given approval.
Avoid twisting your neck to the extremes, and avoid forced bending of your neck either forward or backward. Gentle range of motion of the neck is OK. Do not drive until you have received permission from your physician.
Dr. Amir Vokshoor is a Board Certified neurosurgeon who specializes in the minimally invasive surgical treatment of adult cranial and spinal disorders.
He continues to advance neurological spine surgery through rigorous research and contributions to…
Dr. Jared D. Ament is a Board-Certified, fellowship-trained neurosurgeon known as the “anti-fusion doctor” for his advocacy of motion-preserving spine surgery. He specializes in…
