Know Your Neurosurgeon

Adult Procedures

Cervical spinal derangement is a common condition resulting in compression of the cervical nerves or the spinal cord.

Cervical Nerves

If the cervical nerves are compressed, it may result in pain, mobility problems and altered sensation in the upper limbs. There may also be accompanied neck pain. The aim of treatment is not to correct the neck pain, but rather, to correct and improve arm and hand symptoms. Any improvement in neck pain can be viewed as a bonus.

Spinal Cord

If the spinal cord is compressed, the major problems may be walking difficulties, in coordination in movement or altered sensation. When the spinal cord is compressed, treatment is aimed at stabilizing the clinical state and “preventing the clinical state from getting worse”. It is, often, impossible to gain any improvement in the neurological deficits when the cervical cord is compressed.

Possible Surgeries
  • Posterior cervical foraminotomy and nerve root compression
  • Posterior cervical laminectomy
  • Anterior cervical discectomy and fusion
  • Anterior cervical vertebrectomy and fusion



Foraminotomy

A window of bone is drilled out over the compressed nerve root. This transforms the tight canal into a “half-pipe”, freeing the compressed nerve root.

Laminectomy

The window of bone removed is much larger. This will allow not only the decompression of the nerve root but also the spinal cord. There is no danger in removing a large portion of the spinal canal and lamina as muscle, fascia, subcutaneous tissue and skin will help protect the operative site.

Discectomy and Vertebrectomy

The entire disc and the entire vertebral body are removed respectively at the affected level in the cervical spine. By doing so, the nerve and / or the spinal cord are decompressed. This will destabilise the cervical spinal column. To maintain stability, the affected region is fused with an artificial polymer cage packed with bone stimulating granules and bone (with a cervical metal plate and screws if vertebrectomy is performed).
 

Please discuss with your surgeon the risks and benefits of each option.

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