Cervical spine surgery is a type of spinal surgery generally undertaken to treat one of two conditions: compression or impingement of the spinal cord or the nerves therein; or instability of the spine as a whole. Each issue requires a different cervical spine procedure. Impingement of spinal nerves demands spinal decompression surgery to relieve the pressure, while spinal instability often involves some type of spinal fusion surgery (such as the implementation of a small plate into the spine). In fact, one patient who demands one surgery may sometimes require both. Spinal decompression surgery will often cause issues with spinal stability, thus requiring fusion surgery as well. As such, many spinal surgeons are experienced in combining these two surgeries into a single procedure.
In this post, we will take a closer look at cervical spine surgery, outlining some basic definitions that are good to know, discussing symptoms that may indicate a need for surgery, and delving into some of the things that patients should expect before and after going in for a cervical spine procedure.
What Is the Cervical Spine?
First, let’s clarify a simple definition: what is the cervical spine?
Essentially, the cervical spine is the neck portion of the spinal column. It consists of seven vertebrae (numbered C1 through C7), as well as the discs between those vertebrae. When the cervical spine is healthy, the discs serve to absorb shocks, prevent damage to the vertebrae, and allow seamless movement of the neck. Nerves flow out of the spinal column and the spinal canal, enabling movement of the muscles and tissues throughout the body and ensuring sensation and feeling. As such, any damage to the cervical spine can lead to nerve damage or nerve pain, which can affect the function and sensation of nearby tissues.
Indications That You May Require Cervical Spine Surgery
The good news and bad news here is that any cervical spine injury is going to be very difficult to overlook. Whether it’s a crack or fracture to one of the C1-C7 vertebrae, a pinched nerve, or a herniated disc in the cervical spine, you will experience significant pain with any injury to the cervical spine. Reduced mobility and range of motion should also be expected, as should numbness, tingling, and loss of sensation in different parts of the body.
Make no mistake: injuries to the cervical spine are extremely serious. Any pain or loss of function to this area of the body should prompt an immediate visit to the hospital. Injuries to high-cervical vertebral levels (those to the C1, C2, C3, or C4 vertebrae, or to any corresponding nerves) are the most severe. These injuries can lead to paralysis or quadriplegia. Patients with severe injuries to these areas will often not be able to move on their own or even breathe on their own. Speech may also be impaired or virtually impossible.
Injuries to the lower cervical spinal cord (those involving vertebrae or nerves below the C5 level) have better odds at retaining key motor and sensory functions throughout the body. While injuries to this part of the cervical spine can still lead to paralysis, they are less likely to impair breathing and speech.
Fortunately, the most common type of cervical spinal injury is a herniated disc (also known as a bulged disc, a slipped disc, or a ruptured disc). In this type of injury, there is no actual damage to the vertebrae themselves, which reduces the risk of long-term or irreversible injury consequences. In the case of a herniated disc, a piece of the disc between the spinal vertebrae is pushing or pressing into the spinal canal. Since the space within the spinal canal is limited as is, a disc herniation will typically result in a pinched spinal nerve, which can, in turn, cause extreme pain, loss of function, numbness or tingling, and more. Herniated discs are most common in older individuals, as the discs themselves tend to degenerate as we age. However, straining the spine excessively—such as by lifting a very heavy object—can also cause a disc to rupture, even in younger patients. These injuries are most common in the lower back, but can occur in the cervical spine as well. Slipped discs in the neck or upper spine most often lead to pain in the neck or between the shoulder blades, along with pain, numbness, and tingling that radiates down the arms and even into the hands.
In any case, there can be no trivializing any injury to the upper spine. Never ignore severe neck pain or cervical spine pain, and always consult a doctor about lost range of motion or issues with numbness, tingling, or loss of sensation.
What to Expect from a Cervical Spine Procedure
Cervical spine surgery enables a spinal surgeon to access the damaged or injured part of the spinal cord and repair the problem. The most common type of cervical spine procedure involves removing a damaged disc (called a discectomy), replacing it with a plate and a bone graft, and then fusing that part of the spine to ensure maximum stability. As discussed earlier, this example shows how the two different types of cervical spine surgery—decompression surgery and spinal fusion surgery—often go hand in hand.
This type of surgery can be undertaken in one of two ways: either from the back (posterior) or from the front (anterior). Contrary to what most patients assume, anterior cervical spinal surgery is actually the preferred method among most spinal surgeons. Going in through the front the spine does less damage to crucial muscles around the spine and is less disruptive to spinal alignment. As such, an anterior approach often paves the way for easier, quicker healing and fewer long-term symptoms associated with the surgery.
Dr. Vivek Kushwaha is skilled and experienced in cervical spine procedures, including cervical disc replacement, cervical discectomy, and cervical spinal fusion. If you believe that you may have suffered a herniated disc or some other injury to the cervical spine, please do not hesitate to contact us today and schedule a consultation with Dr Kushwaha.