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.
Posterior Cervical Discectomy and Fusion (PCDF) is a surgical procedure used to relieve compression of the spinal cord or nerve roots in the cervical spine. This compression is often caused by conditions such as herniated discs, degenerative disc disease, or narrowing of the spinal canal. The procedure is performed through a posterior approach, meaning the surgeon accesses the spine from the back of the neck.
The surgery begins with an incision along the back of the neck. Muscles and soft tissues are carefully moved aside to allow visualization of the affected vertebrae. The surgeon then removes the disc material or bone spurs that are pressing on the spinal cord or nerves. After decompression, the surgeon stabilizes the spine using implants such as screws and rods, along with bone grafts to encourage fusion between the vertebrae.
This approach is particularly useful for treating multiple levels of disease or when direct posterior decompression is required. It is also an effective option when previous anterior cervical surgery has failed or is not recommended.
Recovery typically involves a short hospital stay followed by a period of physical therapy to restore strength and mobility. Patients are advised to avoid heavy lifting or repetitive neck movements while the fusion heals. The bone fusion process can take several months, during which regular imaging is used to assess progress.
PCDF offers significant relief from pain and neurological symptoms while restoring spinal stability. It is considered a reliable option for carefully selected patients with cervical spine disorders that do not respond to conservative treatments.
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…
