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 Discectomy and Fusion (ACDF) When conservative treatments fail or if neurological symptoms worsen, surgery may be required. The most common surgical option for herniated cervical discs is anterior cervical discectomy and fusion. This procedure involves making a small incision on the front of the neck to access the spine.
The herniated disc is carefully removed to relieve pressure on the spinal cord or nerve roots. After the disc is removed, a bone graft or spacer is placed between the vertebrae. A small plate and screws may be used to stabilize the area and promote bone healing. Over time, the vertebrae fuse together to form a solid segment, eliminating motion at the affected level.
The primary goal of ACDF is to relieve pain, restore function, and prevent further neurological damage. This procedure has a long track record of success and is widely considered the standard surgical approach for cervical disc herniation with instability.
Though ACDF 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.
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 specializing in minimally invasive surgical treatments. With over 20 years of dedicated experience, he is a leading advocate for advancements in the field, recognized for his expertise in…
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…
