Cervical Spine Surgery

Cervical Spine SurgeryCervical spine surgery, an elective procedure, may be recommended by your doctor because other forms of treatment have been ineffective. When recommended, cervical spine surgery may be the only hope for pain and symptom relief from a cervical spine ailment. For some, making the decision about whether or not to proceed with surgery can be clouded with fear, anxiety and uncertainty. Understanding why the procedure is needed, what it is used to treat, how it is done and what the outcome may be can help in making the best possible choice.

Cervical Spine Surgery – What it is Used for and Why You May Need it

Cervical spine surgery can be used to treat nerve/spinal cord impingement and spinal instability. Nerve/spinal cord impingement is corrected with decompression surgery. Spinal instability is corrected with fusion surgery. In many cases, both procedures are required and both are generally done at the same time. Spinal instrumentation (the insertion of a small plate in between the discs) may also be used to help add more stability to the spine.

How the Procedure is Done

A surgeon can perform cervical spine surgery from either a posterior (the back of the neck) or an anterior (the front of the neck) position. In most cases, surgeons prefer using the anterior approach because it is easier to access the spine from this angle. Musculature preservation and normal alignment of the spine are also easier to accomplish through an anterior approach. There are, however, situations that may require a posterior approach or a posterior/anterior combination.

Anterior Cervical Discectomy and Fusion (ACDF)

An anterior cervical discectomy and fusion, or ACDF, is used to treat a herniated cervical disc. In this procedure, the surgeon approaches the damaged disc through the front of the neck and the cervical disc is removed. The purpose of this procedure is to relieve pressure on the spinal cord or root nerve. In turn, pain, tingling, numbness or weakness caused by the compression is alleviated. During this procedure, fusion is often used to help stabilize the cervical segments on either side of the damaged disc.

To gain access to the damaged disc, an incision will be made on the front of the neck and a small vestigial muscle will be cut. Because only one small muscle needs to be cut, most patients heal quickly from an ACDF procedure, but like all surgeries, there are still risks and complications.

The most common risks and complications associated with an ACDF procedure include reaction to anesthesia, nerve root damage, infection, an inadequate relief of symptoms, bone graft failure, speech problems, persistent swallowing, spinal cord damage, damage to the trachea or esophagus and difficulty swallowing for 2 to 5 days postoperative.

Anterior Cervical Corpectomy

When multi-level cervical stenosis, a condition in which multiple cervical structures are deteriorating, is present, an anterior cervical corpectomy may be used. In this procedure, the damaged vertebrae are removed, along with the discs at either end of each removed vertebrae. Fusion is almost always used with this procedure to restore proper alignment through reconstruction of the spinal column.

Like an ACDF, the procedure is done by approaching the neck from an anterior angle. The incision is generally larger than an ACDF incision and the posterior longitudinal ligament is generally removed to help gain access to the cervical canal and assist in removing all pressure on the spinal cord and nerve roots.

Because there are similarities between an ACDF and a corpectomy, some complications and risks associated with a corpectomy are similar to the risk and complications associated with an ACDF. However, a corpectomy is more difficult and extensive than an ACDF, and as a result, the chances of experiencing those risks is higher. These risks include nerve root damage, bleeding, graft dislodgement, damage to the trachea/esophagus, continued pain, infection and damage to the spinal cord.

Additionally, there are additional risks associated with a corpectomy. These risks include the possibility of quadriplegia and damage to the vertebral artery, which can lead to stroke or life-threatening bleeding. Risk for quadriplegia is somewhat reduced by the use of SSEPs, or Somatosensory Evoked Potentials. This a tool used to monitor the time it takes for signals to reach the brain. If the response time slows, this can indicate compromise of the spinal cord to the surgeon.

Posterior Cervical Decompression Surgery

When a large soft disc herniation on the side of (lateral to) the spinal cord is present, a surgeon may choose a posterior approach over an anterior approach. Unlike anterior approaches, in a posterior discectomy, the incision is made at the back of the neck. Para-spinal muscles are elevated off of the spine so that access may be gained to the cervical vertebrae and damaged disc. No muscles or tendons are cut during a posterior discectomy and a fusion procedure is not needed.

Lack of a fusion procedure does reduce the surgical risk, but there are some notable disadvantages as well, particularly the fact that a bone graft cannot be inserted if it is needed to alleviate pressure on the nerve root. The surgeon must weigh the potential advantages and disadvantages to decide which option might be best for you.

Just like all cervical spine surgeries, there are risks associated with a posterior cervical decompression surgery, but risks with this surgery are rare. The most common complications include nerve root damage, infection, continued pain, spinal cord damage, dural leak and recurrent disc herniation.

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Cervical Herniated Disc: Symptoms, Treatment and Exercises

Cervical disc herniations occur within the neck. Most often, the herniation occurs between the fifth and sixth (C5 and C7) or sixth and seventh (C6 and C7) discs. Other discs, however, can be affected. If you have, or you suspect that you may have a herniated disc, you can learn more about the symptoms, types of treatments and exercises that can help within this article.

Cervical Herniated Disc: Symptoms, Treatment and ExercisesWhat is a Herniated Disc?

Nerves are assigned the complex task of carrying messages from your brain to other parts of your body; including messages of pain, heat and cold. Messages are also sent to tell your heart when to beat and your lungs when to breathe. All of your body’s nerves are encased inside of your spinal column for protection.

Your spinal column is composed of vertebrae, which, much like joints, allow your spine to twist and bend. Also like joints, special cushioning is needed in between each vertebral disc to ensure that the spinal column can move easily and without pain. With age, however, the disc can start to deteriorate. Trauma can also damage the discs found between the vertebrae.

Each disc is composed of two parts; the soft, gel-like inner portion(otherwise known as the nucleus pulposis) and the tough outer wall (otherwise known as the annulus fibrosis). When the disc is damaged, either because of trauma or age, small tears occur in the fibrous outer wall. This allows some of the nucleus to leak out. Over time, these parts can harden and break apart. Eventually, these pieces push through the small tears in the wall, often pushing on or compressing a nerve root. This is what causes the pain often associated with herniated discs.

Cervical Herniated Disc Symptoms

Pain in the back of the skull, neck, shoulder girdle, shoulders, scapula, arms and hands are all symptoms associated with a herniated cervical disc. Arm pain, which may extend into the fingers, is the most commonly reported cervical herniated disc symptom. Tingling and numbness may also accompany the pain often felt from a herniated cervical disc. Muscle weakness and damage to the cervical plexus and brachial plexus nerves may also occur.

Cervical Herniated Disc Treatment

In many cases, a cervical herniated disc will repair itself with a little time and rest. It is for this reason that conservative treatments are generally exhausted first; short periods of rest and possibly pain medications or muscle relaxers or NSAIDs. Physical therapy is often included in the treatment plan as well, but not always. Should these treatments prove to be ineffective, a physician may use choose to exercise more progressive treatment options.

Steroid injections and anti-inflammatory drugs may be given if rest and physical therapy are not effective forms of treatment. Anti-inflammatory drugs may also be used as a type of long-term therapy to help reduce pain and symptoms. In some cases, however, surgical intervention may be needed.

Few people require surgical intervention to treat their cervical herniated disc, but if it is required, then your doctor feels it is necessary. The procedure is done as an outpatient procedure in the hospital and you are placed under general anesthesia during the entire surgery. Part of the disc and nucleus may be removed, along with any other material that may be compressing the nerve. Certain risks, such as a reaction to the anesthesia, bleeding or damage to the nerves that surround the spine can occur.

Exercises That Can Help Cervical Herniated Discs

In addition to physical therapy, your doctor or physical therapist may prescribe exercises for you to do at home. This is an essential part of your treatment and you should do these exercises as often as recommended. In most cases, your doctor or physical therapist will show you how to do the exercises or offer you an instructional sheet that describes the exercises.

Stretching is commonly recommended as a part of your herniated cervical disc treatment. Stretching helps to improve and maintain mobility of the spine and it provides oxygen and nutrients to the spine and muscles of your neck.

Stretching the neck should be done in motions that move your neck both side to side and up and down (flexion and extension). You should also turn your neck so that you look from right to left and left to right. When performing stretching, it is important to stretch slowly and to never extend your neck beyond your pain threshold. Overstretching can cause more damage to your neck.

Another exercise, known as the McKenzie back exercise may also be recommended. Created by Robin McKenzie, these stretches are designed to help treat and alleviate cervical neck pain. There are six different exercises included in the McKenzie back exercises, all of which progressively relax different sections of your back and spine so that you can reduce

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Acupuncture for Herniated Discs

Acupuncture for Herniated DiscsHerniated discs can cause excruciating back pain and traditional medical alternatives aren’t always the best choice. Sufferers either have to contend with mild relief or take so much pain medicine that they can’t function normally in their daily lives. The good news is that acupuncture for herniated discs is proving to be an effective treatment for relieving the sciatic pain that is associated with herniated discs.

Treating herniated discs is often a choice between treating the pain and learning to live with some discomfort or undergoing an invasive surgery that is not guaranteed to be a permanent option. The medications involved in treating herniated discs are typically steroidal and can’t be sustained for long periods of time. These are just some of the reasons that acupuncture is becoming a popular treatment option for many people.

What is Acupuncture?

The practice of acupuncture is very old and has been used for pain in many areas of the body. During an acupuncture session, tiny needles are strategically placed over the body in areas that are known as acupuncture points. These points have been discovered over time to relate to certain areas of the body. The acupuncturist knows where to place the needles based on where the pain is located. The needles are typically left in place for fifteen or twenty minutes. Many people report that the pain is completely healed after several sessions.

Many people have doubts about acupuncture’s pain relieving abilities and may also be afraid that the needles will hurt. These people should know that the majority of people report feeling no pain when the needles are inserted. As for the pain relieving quality of the process, acupuncture has been used for more than a thousand years to treat pain and to treat many different diseases.

Acupuncture and Back Pain

Acupuncture has been used for back pain for many years and is now the choice of many doctors. In order to get the most benefits from acupuncture for a herniated disc, it is important to start the process as quickly as possible after a diagnosis. The doctor who diagnosis the herniated disc can determine how much disc damage exists and if acupuncture is a viable treatment option. The acupuncturist may also suggest herbal medications to help with pain and possibly even light exercises.

One of the reasons that starting the treatment early is that the procedure has been shown to encourage the body to produce its own natural steroids which aid in repairing the disc. Endorphins are also released when acupuncture is performed which makes the pain less severe and for some people completely stops the pain. The combination of the natural steroid and endorphins also help to reduce the amount of swelling around the disc which in turn facilitates lowering the level of pain.

There are many advantages to acupuncture that may be experienced. Unlike pharmaceutical treatments, these side effects are often welcome and add to the positive outcome the acupuncture offers. One of these is being less fatigued and having a better mood than before the acupuncture. This is in part due to diminished back pain and in part due to the actual acupuncture process.

It is important to remember that every person’s body is different and not everyone will respond to acupuncture the same way. The acupuncturist will also play a role in how much relief the process provides. The person inserting the needles must be very knowledgeable in their field and know precisely where to insert the needles to obtain the maximum benefit. This makes it important to choose a qualified doctor with a strong reputation in field.

Benefits of Acupuncture

Acupuncture has many more benefits than alleviating back pain. It has proven to be helpful in many other painful conditions such as migraines, chronic neck and leg pain, and carpal tunnel syndrome. This prickly procedure has proved beneficial in helping people stop smoking, lose weight, become less anxious and even reduce stress. These examples show that acupuncture for herniated discs is just one more reason that acupuncture is popular treatment option.

One of the greatest benefits that acupuncture offers is freedom from pain while at the same time being free from the side effects of many pain medications. Pain medications often make it hard to function with a clear head; on the other hand, acupuncture has no effect on the thinking clearly and can actually make the patient feel much better overall. People who are on pain medications are often unable to work due and need someone to help with their daily life activities. People who choose acupuncture can often return to work and daily activities in a short time with little or no pain.

Acupuncture for herniated discs is a consideration that anyone with the condition should discuss with their doctor. The benefits are tremendous and the side effects positive.

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