Anterior cervical discectomy surgery
What is anterior cervical discectomy surgery?
An anterior cervical discectomy is the most common surgery used to address damaged discs (shock-absorbing cushions between the vertebrae of the spinal column) in the neck. During this procedure, your spine surgeon will remove the ruptured disc(s) and any remaining fragments that are compressing the spinal cord or the nerve roots that branch out from it.
This surgery is commonly performed in conjunction with cervical fusion surgery, a procedure that replaces the damaged disc with bone graft material to fuse together the surrounding vertebrae. Cervical fusion allows normal height and stability to be maintained in the spinal structure. Since a bone graft can take several months to fuse with adjacent vertebrae, the surgeon may secure and support the bone graft with a metal plate, rod and screws (known as instrumentation) fastened to the spine and vertebrae surrounding the bone graft.
Herniated discs and the spinal cord
The vertebrae in your spine protect the nerve bundles that lead from your brain all the way down the spinal cord. The nerves branch out from your spinal cord by traveling between the vertebrae to reach other parts of your body. The vertebrae are separated and protected by discs, which act as flexible cushions. The discs give the spine mobility while preventing the vertebrae from rubbing against each other.
When a disc is damaged it collapses and dries out, beginning a series of events that happen like dominos falling. The space between the vertebrae decreases, resulting in loss of body height. Additionally, the neural foramina (openings) around the spinal nerves narrow and cause compression of the nerves. The ligaments of the spine become slack and put pressure on the spinal cord.
As the disc collapses, the outer layer of the disc (annulus fibrosis) forms cracks. The nucleus pulposus (gel) inside the disc begins to seep out through the cracks and compresses the ligaments, nerves and surrounding boney structure. This condition is referred to as a herniated or ruptured disc. When the disc fragments put pressure on the nerves or soft tissues of the spine, it can cause tremendous pain, weakness and spinal instability. Pressure on the spinal cord, known as myelopathy, can cause bowel and bladder problems, irregularities in the way you walk and even disruption of the fine motor skills of your hands.
Why it's done
The most common reasons for performing anterior cervical discectomy surgery are:
- Degenerative disc disease—Through normal wear and tear, an affected disc dries out and shrinks, losing its flexibility and cushioning properties. Bone spurs form and inflame surrounding tissue. All of these changes eventually lead to a ruptured disc in the spine.
- Cervical spinal stenosis—This condition consists of a narrowing of the spinal canal in the neck. This narrowing causes the nearby discs to flatten, bulge and eventually rupture.