Anteriror cervical spine surgery
Anterior cervical spine surgery is performed when there is pressure or compression over the spinal nerves. The pressure can be at multiple level in multilevel cervical myelopathy or single level in cervical disc herniation.
Indications for Surgery:
- Severe pain.
- Pain more than 3 weeks, not relieved by medications.
- Progressive weakness in upper or lower limbs.
- Tingling, numbness in upper and lower limbs
- Imbalance while walking, difficulty in performing fine motor activities
- Difficulty in passing urine and stools or inability to control urine and stools.
Procedure
Anterior cervical spine surgery includes:
- Anterior cervical discectomy and fusion.
- Anterior cervical corpectomy and fusion.
Anterior cervical discectomy and fusion
Anaesthesia: The surgery is performed under general anaesthesia with the patient lying face up on the operating table.
Surgery: After cleaning the area of surgery thoroughly, the level of surgery is confirmed under X ray machine. A small incision is made of about 2-4 cm at the level of surgery. The spine is exposed by retracting muscles, blood vessels and visceral organs. The level of surgery is again confirmed with the help of X ray machine. The disc material is removed to achieve decompression of the spinal cord. A bone graft taken from the pelvic bone or interbody titanium cage is inserted and a plate is put over the bone to achieve stability of the spine.
After Surgery
In the recovery room: Immediately after surgery the patient is shifted to recovery room, where the patient is monitored for some time. Medications are provided for pain to control post operative pain relief. Once the patient is comfortable the patient is shifted to ward. A hard cervical collar is given for support and reduce muscular spasm.
In the ward: The patient is allowed to have liquids 6 hours after the surgery. Once the pain has reduced and the patient is comfortable, patient is allowed to sit and walk on the same of the surgery. The patient is discharged 2-3 days after surgery.
After Discharge:
- It is necessary to stay active after surgery and patient can walk as per his comfort with in his home or nearby.
- The patient should follow healthy eating habits avoid weight gain and obese patient should try to reduce weight.
- The patient should refrain from smoking cigarettes, chewing tobacco and drinking alcohol as these can lead to recurrence of symptoms later.
- Patient should do exercise atleast for 45 mins to 1 hour daily to get good result after spine surgery and avoid future spine related problems.
- The soft cervical collar is worn for 3-4 weeks after which strengthening exercise is started for neck muscles
Anterior cervical corpectomy and fusion
Anaesthesia: The surgery is performed under general anaesthesia with the patient lying face up on the operating table.
Surgery: After cleaning the area of surgery thoroughly, the level of surgery is confirmed under X ray machine. A small incision is made of about 2-4 cm at the level of surgery. The spine is exposed by retracting muscles, blood vessels and visceral organs. The level of surgery is again confirmed with the help of X ray machine. The disc material is removed from the level above and below the level of corpectomy. After removal of discs the vertebral body is removed to achieve decompression of the spinal cord. A bone graft taken from the pelvic bone or interbody titanium cage is inserted and a plate is put over the bone to achieve stability of the spine.
After Surgery
In the recovery room: Immediately after surgery the patient is shifted to recovery room, where the patient is monitored for some time. Medications are provided for pain to control post operative pain relief. Once the patient is comfortable the patient is shifted to ward. A hard cervical collar is given for support and reduce muscular spasm.
In the ward: The patient is allowed to have liquids 6 hours after the surgery. Once the pain has reduced and the patient is comfortable, patient is allowed to sit and walk on the same of the surgery. The patient is discharged 3-4 days after surgery.
After Discharge:
- It is necessary to stay active after surgery and patient can walk as per his comfort with in his home or nearby.
- The patient should follow healthy eating habits avoid weight gain and obese patient should try to reduce weight.
- The patient should refrain from smoking cigarettes, chewing tobacco and drinking alcohol as these can lead to recurrence of symptoms later.
- Patient should do exercise atleast for 45 mins to 1 hour daily to get good result after spine surgery and avoid future spine related problems.
- The soft cervical collar is worn for 3-4 weeks after which strengthening exercise is started for neck muscles.