Definition and Overview
Cervical spine surgery, or C-spine surgery, refers to several different types of surgical procedures performed in the area of the spinal column, which runs from the base of the skull to the lower portion of the neck. The objective of these surgeries is to alleviate neck pain, improve neck's range of motion, or correct spine alignment.
The majority of cervical spine problems that require surgery originates at the facet joints that allow the neck to move in different directions, the cervical discs that act as shock absorbers between the vertebrae, or the nerve roots. Some of the most common problems are:
Neck arthritis – also called cervical spondylosis, this is a type of degenerative cervical disc disease
Herniated disc – also referred to as a “ruptured” or “slipped” disc
Congenital torticollis – a congenital disorder described as a twisted neck
Cervical fractures – Fracture of one or more of the bones in the neck
Cervical radiculopathy – Also referred to as a pinched nerve, this occurs when a nerve in the neck becomes irritated or compressed causing significant pain
The majority of problems that affects the cervical spine can be treated with the following surgical procedures:
Artificial disc replacement - As the name suggests, this replaces a damaged disc in the spinal column with an artificial disc. The procedure is performed primarily to alleviate pain and improve spinal column's range of motion.
Anterior cervical discectomy and fusion – This involves the removal of an herniated disc and fusing the remaining segments together. The surgery is performed using the anterior approach, which means accessing the spinal column through the front of the neck.
Posterior cervical laminoforaminotomy- This involves removing bone or a herniated disc from the spinal column through the posterior or back portion of the neck.
Who Should Undergo and Expected Results
C-spine surgery, although highly effective in relieving pain in the cervical spine, is usually performed only when all non-surgical treatment methods fail to improve the patient’s condition. The common objective of the surgery is to relieve pain and other symptoms. By doing so, the range of motion of the neck improves, as well as the patient's quality of life.
Patients who elect to undergo any type of C-spine surgeries are likely to stay in the hospital for up to one week and they are expected to fully recover after one to two months. Those who are suffering from neck and arm pain can expect a higher chance of being relieved from the arm pain than the neck pain. However, this does not mean that neck surgeries have low success rates. It only implies that patients should have the correct expectations, which the doctor will explain before the patient decides to undergo surgery.
How Does the Procedure Work
Many patients who undergo surgery fail to realize that the success of the procedure relies not only on the skills of the surgeon or the quality of the facilities, but also on the cooperation of the patient. Each surgical procedure is performed differently, but the preparations for such surgeries are more or less the same.
Before physically preparing for the surgery, patients should prepare themselves mentally. This begins with discussing the procedure with the doctor and knowing what to expect during and after the procedure. The more the patient is mentally prepared, the greater the chances that he is relaxed during the procedure. This contributes significantly to the success of any type of surgery.
A day before the scheduled surgery, the doctor will have the patient refrain from eating foods or drinking water as part of the preparation. However, as much as possible, the patient should begin preparing even weeks ahead, especially if he is a smoker. Quitting smoking well ahead of the surgery helps hasten the recovery process.
Cervical spine surgeries can be performed using the anterior or posterior approach. The former means that the surgery is performed in front of the neck, while the latter means the incision will be made at the back of the neck. Doctors decide on which approach is best depending on the location of the problem.
Patients undergo a series of imaging tests, such as MRI, CT scan, and x-ray prior to the procedure so the doctor can correctly identify the location of the problem and the best method to access it during surgery.
After the procedure, the patient will spend at least a day at the hospital. However, some types of surgeries will require more than three days of hospital stay, longer if complications develop and require immediate treatment.
Possible Risks and Complications
Any type of surgical procedure has associated risks and possibilities of complications. However, in neck surgeries, the risks increase due to the very nature of the neck, which is filled with nerves and blood vessels that carry blood and electrical signals from the brain to different parts of the body.
Possible risks and complications include:
- Nerve damage
- Failed surgery (symptoms not relieved)
- Spinal cord injury
- Heart attack or stroke
Damage to the vocal cords (for surgeries that use the anterior approach)
American Academy of Orthopedic Surgeons