Cervical Spine Surgery

Ashvin Patel M.D. FAAOS

Goal - The goal of the surgery is to relieve pressure placed on the spinal nerves by disc material or a bone spur that is pushing against the spinal nerve.

MRI  (Magnetic Resonance Imaging) - Is the diagnostic test of choice to assist in determining if there is an area of disc material or a bone spur pushing on the nerve. It is an advanced radiology test  where the patient is placed inside a magnetic field which can create detailed images of areas inside the body. Usually, dyes are not given, therefore, there are no needles, IV’s or catheters placed in the patient.

Surgery  -  The procedure is performed in the operating room under general anesthesia and typically takes 2 to 4 hours. Patients are admitted to the hospital the day of the surgery and usually go home in 2 days, however, depending on the individual patient and the extent of the procedure, a longer hospital stay may be needed. Since the disc is removed completely during the surgery, a bone graft  is taken from the hip area and placed into the disc space. Placing the bone graft into the disc space will result in a fusion of 2 vetebral bodies to form one. If more than one level of disc is damaged and causing symptoms, 2 or even 3 levels can be fused together using bone grafts. A metal plate is then screwed onto the vetebral bodies at the site of the surgery to aid in accomplishing the fusion.

Immediately after Surgery

·        Most patients have significant improvement in arm symptoms immediately after surgery.

·        Patients usually go to the orthopedic unit after recovery.

·        There is usually a sore throat and hoarseness for the first few days after the surgery

·        The physical therapy team assists patients with walking the day after surgery.

·        Patients begin to drink fluids and are advanced to a soft diet within 48 hours after surgery.

·        A cervical collar is worn to rest the neck muscles and to assist in stability during healing.

·        Home health agencies can be used to do dressing changes and assess patients at home.

First 2 Weeks After Surgery

·        During this phase the neck and graft incisions begin to heal and become much less painful.

·        The arm symptoms from the nerve compression usually improve rapidly.

·        Daily dressing changes are required but are quite easy to do.

·        Sponge baths are recommended until the first office visit one week after the surgery.

·        Daily walking is the only physical therapy. There should be no excessive activity such as sports or heavy lifting.

2-6 Weeks After Surgery

·        Routine daily activities are permitted, but excessive activity is not advised.

·        Most patients do not need any pain medications during this period.

·        If residual arm or hand weakness is present as a result of the compressed nerve, physical therapy started to strengthen these muscles.

·        There are no bathing limitations.

·        The cervical collar is worn for 6 to 8 weeks  while the vertebrae are fusing

·        Most return to work doing light duty activities at 2 to 3 weeks.

·        Physical Therapy is prescribed once the bone graft has healed to strengthen the cervical paraspinal muscles.