Medical Health Encyclopedia

Spinal surgery - cervical

By physical examination, a doctor (usually a neurologist, orthopedist, or neurosurgeon) can often determine the exact location of the trouble. The physician will test sensation, muscle strength, and reflexes, and perform a number of other special tests to determine where the problem lies.

The treating doctor will also usually order X-rays and an MRI, which will help confirm the diagnosis and will help the physician develop an appropriate treatment plan.

Other less common conditions that can cause problems in the cervical spine include fractures, tumors, and infections.

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The specific surgery depends on the exact nature of the problem. The surgery is conducted while the patient is under general anesthesia (unconscious and pain-free).

If there is a single herniated disk, then the disk may simply be removed through an incision either through the front or back of the neck.

If there is more than one disk that needs to be removed, then the spine usually needs to be fused to keep it from becoming unstable. For surgery from the front that means that bone is placed in the space where the disk was removed and plates are screwed into the vertebrae to keep them from moving. Rods are sometimes used to connect the vertebrae if the surgery is done from the back.

Spinal stenosis is a more difficult problem to treat and generally requires more extensive surgery. The spinal nerves and cord need to be decompressed and this can again be done from either the front or the back. Again, if there is enough bone taken away that the cervical spine becomes unstable, it will be necessary to fuse the remaining bone together with bone and plates, rods, or metal cages. The bone may be taken from the patient's body, usually from either the hip or the lower leg.

Indications:

For most cervical spine problem, the initial treatment will be non-operative and may consist of rest and anti-inflammatory medications. Some people with cervical problems may benefit from neck braces. As the pain improves, physical therapy will have a role in preventing recurrence of pain.