Cervical disc surgery

Cervical disc surgery

Dr. Mahmoud Yazdan Panahi
Dr. Mahmoud Yazdan Panahi
Tehran
Some common cervical disc treatment options other than surgery include the following: - Rest. - Using ice or heat. - Using a soft neck necklace. The necklace helps to support and immobilize the neck. - Avoidance of intense or aggravating physical activity. - Physiotherapy. - Using medications, including muscle relaxants, pain relievers (such as acetaminophen) and anti-inflammatories (such as ibuprofen and naproxen). Steroid injection: Two specific types of steroid injection are considered for cervical disc. A cervical epidural block is a procedure in which a steroid is injected into the epidural space (the space next to the covering of the spinal cord). A cervical facet joint block is a procedure in which a steroid is injected into the capsule (connective tissue covering) of the facet joint (the small joint above and below each vertebra that connects the vertebrae to allow movement). - Branchial block and radiofrequency ablation: this method is considered in some cases of chronic neck pain. First, a local anesthetic is injected into the nerve that supplies the facet joint of the vertebrae. If your pain is relieved, the next step is to make the pain relief permanent. This is done by damaging your nerve with a technique called radio ablation. Pain relief takes months. If your nerve regenerates, the pain may return. Cervical disc surgery Cervical disc surgery is a general term that refers to a variety of procedures used to relieve symptoms caused by pressure or pressure on the spinal cord or nerve roots in the neck. Nerve roots are the first part of a nerve that exits the spinal cord through the small holes between the vertebrae. You may be a candidate for cervical disc surgery in these cases: - Other treatments do not help to resolve the cervical disc. - Symptoms related to cervical disc worsen. - You are healthy enough to perform cervical disc surgery. Is cervical disc surgery dangerous? It is necessary to mention that other methods are usually used before using cervical disc surgery. With the ineffectiveness of other methods, it is necessary to use surgery. Cervical disc surgery, like any surgery, has benefits for the patient, and naturally, there is a possibility of risks or complications. Choosing the right surgeon as well as following the instructions given by the surgeon during the recovery period can reduce the possibility of risks after surgery to the lowest possible level. Types of cervical disc surgery Common surgical methods include the following: **Cervical discectomy:** In this procedure, the surgeon removes a part of the disc to reduce the pressure on the adjacent nerve roots. **Laminotomy or cervical laminectomy:** In these procedures, the surgeon removes a small part of the bony arches of the spinal canal, called the lamina. In laminotomy, only a small part of the lamina is removed. The entire lamina is removed in a laminectomy, along with any bone spurs, disc material, and thickened ligaments as needed. Removing the lamina increases the size of the spinal canal, which reduces the pressure on the neck area. **Foraminotomy or Cervical foraminectomy:** Both of these procedures are done to open openings for nerve roots to exit the spinal cord by removing some bone in that area. In foraminectomy, a large amount of bone is removed. Cervical corpectomy: In this surgical procedure, the surgeon removes the vertebral body (the large front part of the vertebra) as well as the disc to reduce pressure on the spinal cord. In some cases, this is followed by vertebral fusion (which permanently joins two or more vertebrae together) to stabilize the cervical spine. ### Cervical disc surgery from the front Frontal cervical disc surgery is one of the types of cervical disc surgery in which, at first, the surgeon creates 2 to 3 cm incisions in the front of the neck of the operated person and provides enough space to pass through the muscles and vessels and reach the cervical disc. In the next step, the exact location of the lesion is determined during surgery with a radiographic device. Then, using a microscope and surgical tools such as an arterator, the joint fluid removed from the disc is drained, and after that, with the help of a microscope, the lips of the damaged area and the bones that put pressure on the spinal cord and nerve roots are released. Also, other causes of cervical disc are removed and filled using special tools. Sometimes artificial discs are used to fill the empty space of the cervical disc. ### Cervical disc surgery from the back Cervical disc surgery from the back is one of the applied cervical disc surgery methods, which, in addition to cervical disc surgery, has many advantages in diseases such as spinal canal stenosis or OPLL disease. In cervical disc surgery, after anesthesia, the patient is placed on his stomach and a 10 cm incision is made on the back of his neck. In the next step, the muscles, vertebrae and bones that have put pressure on the spinal cord and nerve roots are completely removed so that the spinal cord is completely freed and the pressure on the neck is removed. In the next step, the leaking cartilage fluid is collected and, if necessary, the ruptured disc that causes pressure on the spinal cord is removed or replaced with artificial discs. Sometimes, fusion or screw placement or bone grafting from behind the neck vertebra is used to completely improve the neck disc problem. ### Endoscopic cervical disc surgery In this method, the patient is put under local or spinal anesthesia, and in the next step, a very small skin incision (about 7 mm) is made in the neck area with the help of an endoscope. In the next step, the surgeon removes the protruding disc or the thickened ligament with the help of a narrow tube like canal. This surgery is performed in a very short time (30 to 45 minutes) and the surgical site is closed with a small dressing. ### Cervical disc surgery with laser In this method, the surgical site is analyzed and prepared with the help of radiology, and in the next step, a thin needle is inserted into the ruptured disc. In the next step, a special optical fiber is inserted into the patient's body and the laser energy is transferred to the ruptured disc through this fiber. Laser radiation to the cervical disc causes various parts of the gelatinous liquid inside the cervical disc to evaporate gradually. Then the remaining materials are taken out from the target area and the spinal cord and nerve roots are freed and the inflammation and pain subsides. Another advantage of Laser disc surgery in the neck is the small changes in the neck area of the operated person, which makes it unnecessary to use an artificial disc in the neck area. Complications of cervical disc surgery It can include the following, and in this case, the person undergoing surgery must inform his doctor about the occurrence of these risks: - Fever over 101.5 degrees (not relieved by Tylenol). - Intractable nausea or vomiting. - Severe intractable pain. - Infection of the surgical area. - rash or itching at the cut site (allergy to Dermabond skin glue). - Swelling and tenderness in the leg. - New onset of tingling, numbness or weakness in arms or legs. - Dizziness, confusion, nausea or excessive sleepiness. ### Paralysis after cervical disc surgery This complication rarely occurs, and if it occurs, it is necessary to send the operated person to the hospital as soon as possible and make the necessary decision in consultation with the surgeon. ### Care after cervical disc surgery Usually, the operated person is admitted to the hospital one day after surgery and then discharged. It is essential that the person having surgery follow the surgeon's home care instructions for 2 weeks after surgery or until their next visit. Generally care after cervical disc surgery includes the following: - Avoid bending or turning the neck. - Don't lift anything heavier than 5 pounds. - Don't do any vigorous activity including yard work, housework and sex. - do not drive until the next visit and consultation with your surgeon. - Know the most common symptoms of cervical disc and inform your surgeon if they return. ### Physiotherapy after cervical disc surgery Physiotherapy after surgery is started 4 to 12 weeks after surgery and lasts for 6 to 12 weeks. The guidance and instructions necessary to do it and the desired recommendations to be followed during the physiotherapy are issued by the surgeon and must be applied by the person who underwent surgery. ### Nutrition after cervical disc surgery To ensure the success of the cervical disc surgery, the operated person should: - Do not smoke or use products containing nicotine. Nicotine prevents the growth of new bones and may increase the risk of cervical disc surgery. - Do not drink alcohol: alcohol and alcoholic beverages dilute the blood and increase the risk of bleeding. Also, the operated person should not mix alcohol with painkillers. Examining the costs of cervical disc treatment The cost of cervical disc treatment varies from 2 million to 20 million. If the treatment is non-invasive and only through medication, the costs will be less than 2 million. In any case, several factors are influential in determining the cost of cervical disc treatment. Among the most important factors affecting the cost of cervical disc treatment, the following can be mentioned: ### 1) The level of skill, experience and expertise of the doctor Doctors who have high knowledge and expertise follow the surgery with more precision and detail; Therefore, their salary may be slightly higher than other doctors. ### 2) The amount of damage to the cervical disc The severity and extent of the damage is another determining factor in the cost of treatment; Because this will increase the complexity of the treatment. ### 3) Type of therapeutic technique As mentioned, cervical disc treatment is performed in two invasive and non-invasive ways. Cervical disc herniation will cost more than minimally invasive methods. ### 4) Type of hospital and treatment center Surgery is more expensive in private and progressive hospitals than in public hospitals. ### 5) Geographical location Cervical disc surgery will be more common in big cities due to the presence of advanced clinics and the concentration of specialist doctors. **Everything discussed aboutcervical disc treatment methods Cervical disc is one of the common spine problems. Aging, injuries, and injuries can cause a herniated or ruptured cervical disc. The treatment of this facial complication is invasive and non-invasive. Before performing the cervical disc herniation, the doctor performs the treatment in the form of medicine, physiotherapy, chiropractic and neck brace. In case of non-invasive techniques, neck disc surgery will be performed from the front, back or simultaneously. Cervical disc treatment will be excellent and successfulif the treatment process is performed by skilled and experienced doctors like Dr. Mahmoud Yazdan Panahi. He is a specialist in neurosurgery, spine surgery and endoscopy of the brain and has been able to obtain the top rank of the specialized board in this field.

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