Surgical procedures may be considered in the event that conservative therapy does not bring about sufficient improvement in symptoms (that is, pain, numbness, tingling, and/or weakness in the arms). Surgery should also be considered when there is significant Compression of the spinal cord with signs of cord dysfunction or myelopathy, as these symptoms and signs may be permanent even after surgical decompression. Symptoms of spinal cord dysfunction or myelopathy include decreased balance, difficulty walking, feeling of clumsiness in the legs, loss of coordination and fine movement skill of the hands, and problems with urination.
Surgical treatment for herniated cervical discs varies according to the severity of the injury. One method is known as a foraminotomy and microdiskectomy. It involves the open removal of the part of the herniated disc that puts pressure on the nerve root. The entire disc is not removed. This procedure is performed through an incision in the back of the neck. This is usually an outpatient procedure, meaning that the patients usually goes home the same day of surgery.
The most common surgical method used to treat a cervical disc herniation is known as anterior cervical decompression and fusion. Like a foraminotomy and microdiskectomy, this operation involves an open incision, dissection of muscle and tissue. This procedure is performed through an incision in the front of the neck. Unlike a foraminotomy and microdiskectomy, this procedure involves removal of the entire disc, placement of a bone graft, plate and screws. This procedure achieves a fusion at the involved level of the cervical spine. Many patients may be up walking the same evening or the next morning after surgery. Most patients stay overnight in the hospital and then go home the next day. Some discomfort when swallowing, from retracting the esophagus, commonly occurs, but this is usually a mild resolves in the first few days to weeks after surgery.
People who have experienced a herniated disc, whether treated conservatively or with surgery, are advised to become knowledgeable about caring for their neck - using proper lifting techniques, practicing a specific set of stretching and strengthening exercises, and modifying their activities to protect the neck. All of these measures may significantly reduce the chance of repeated injury to the spine.
