SURGICAL OPTIONS FOR CERVICAL HERNIATED DISC

I think many of our patients who use the internet effectively already have knowledge of the formation of a cervical disc hernia. I want to share with you here the question that occupies the minds of our patients the most: What is the path to follow in the treatment of cervical disc hernias? In the treatment of cervical disc hernias (as in the medical terminology we use), it is possible to achieve success with non-surgical treatment procedures. Some of the primary non-surgical treatment procedures include movement restriction, rest-cure, physiotherapy programs and cervical injections.

Surgical treatment option is recommended to patients suffering from loss of strength, who have been diagnosed with significant spinal cord and/or nerve root compression and have not responded to the abovementioned medical treatment. Just like lumbar disc herniation, cervical herniation arises from the structures called ‘intervertebral discs’, as well. A hernia creates pressure on the spinal cord and/or the nerve roots.

After your physical examination and radiological scans, your neurosurgeon decides on whether an anterior or posterior approach will be used in the surgery. Location of the hernia and the surgeon’s experience are important factors for this decision. For anterior approach, usually the right side of the neck is used. After making a 4-5 cm lateral incision, the subcutaneous tissue and the superficial muscle layer just beneath it are passed through and then the progression is continued through the cervical muscles until the carotid artery becomes visible. The carotid artery is retracted outward and the esophagus and trachea are retracted inward using special retractors, with intent to reach the frontal part of the cervical vertebrae. During surgery, an x-ray is taken with intent to determine the intervertebral disc to be operated. Afterwards, the refractors are placed. The rest of the process after this phase is microdiscectomy, a surgical procedure performed under a microscope. In this approach, implants or bone parts are placed in the place of the discharged disc material, with intent to fix the two adjacent vertebrae. Afterwards, the surgical distance is checked with a last x-ray, and then the operation is ended after a bleeding control, by closing the incision site in such a way as not to require suture removal. A more limited number of operations are performed with a posterior approach. However, a posterior approach can be recommended if the hernia is not in the midline and is located at the entrance of the canal, where the nerve root arising from the spinal cord enters when leaving the spinal canal.