Neck Surgery
The Cervical Spine
The cervical spine consists of seven cervical vertebrae that support the head and neck. The first of these vertebrae (C-1) is called the atlas and has no disc separating it from the second vertebrae (C-2). The other five vertebrae are separated by discs that serve to cushion each vertebrae, allowing for smooth movement.
The Cause of Spine Problems
A nucleus (soft center) and an annulus (tough outer rings) make up each disc. One of the most common reasons for cervical spine problems is an injured disc. A herniate, sudden movement, or gradual deterioration will damage the disc. When discs deteriorate, abnormal bone spurs often form on the vertebrae or in the foramina, causing the onset of stenosis. Stenosis results in weakness, pain, and loss of coordination.
When the nucleus bulges through the annulus or the annulus tears, the disc is said to be herniated. If the herniated portion of the disc presses against a nearby nerve, you will feel pain in your neck or arms.
If deteriorated, the disc is not herniated but flattened. This allows the surrounding vertebrae to touch, pinching the nerves running through the foramen. If bone spurs form, the nerve will be further irritated.
Your Doctor's Role
In order to evaluate a suspected spine disorder, an X-ray must be taken. X-rays can reveal cervical spondylosis, but a herniated disc will be hidden as it is composed of tissue and not bone. An MRI is necessary for your doctor to find a cervical disc herniation. As MRI tests offer clarity of disc material, cord compression, and root compression, they are useful tools in finding cervical disc herniation. However, sometimes additional bone detail is required. In these cases, a myelogram/CT is obtained which is more invasive than an MRI but may hold the answer in tracing the cause of your cervical spine problem.
Good Candidates for Surgery
Many people with cervical problems may improve with rest and medication. Surgery is usually prescribed for those with an unstable fracture or when symptoms worsen and conservative treatments have failed. If there is considerable compression of the spinal cord with cord dysfunction, surgery should also be considered.
Cervical spine surgery is most appropriate for those with herniated discs in addition to one of the following:
- Degenerative Disc Disease (DDD)
- Fractures
- Spinal Stenosis
- Deformities
- Symptoms do not improve after six to eight weeks of conservative therapy
- Tumor
- Spondylolisthesis
- Pseudoarthrosis
Poor Candidates for Cervical Spine Surgery
Cervical spine surgery is not a recommended option for people with one of the following conditions:
- Local inflammation at the bone site
- Rapidly progressive joint disease
- Metal allergies
- Systematic infection
- Bone absorption syndromes
The Mechanics of Cervical Spine Surgery
Surgical treatment for the cervical spine is commonly approached from the front (anterior). From the back (posterior) operations, however, are becoming more common. The anterior approach often requires a fusion to add stability to your neck.
Normally, your doctor will make an incision one to three inches long (either vertical or horizontal) on either side of your neck. After moving soft tissue to the side, the surgeon reaches your disc and removes it. After removal, your surgeon may prepare the vertebrae for a fusion.
In the fusion process, your doctor joins the vertebrae above and below the removed disc with a bone graft. When inserted into the disc space, the surgeon may use a cervical plate to add stability to the neck and reduce the recovery time.
K2M Anterior Cervical Implants
K2M makes anterior cervical implants (often referred to as plates) that can stabilize the spine from C2 to C7. Once your surgeon has removed the injured disc and prepared the vertebrae for fusion, the K2M cervical plate is placed over the vertebral bodies above and below the removed disc. The plate helps maintain proper alignment and stability.