Microscopic Posterior Cervical Discectomy

Microscopic posterior cervical discectomy is a surgery that is performed for a herniated disc in the cervical spine that is causing the patient neck pain along with radiating shoulder or arm pain.  The surgery can be done either minimally invasively with a tubular retractor or with a small, formal open incision.  The goal of the surgery is to remove the herniated disc to relieve the neck and arm pain of the patient.  The surgery removes bones and/or portions of a herniated or diseased disc to relieve neck and radiating arm pain caused by parts of the disc pressing on nerve roots.  If the surgery were to be performed minimally invasively, a small incision in the back, a wire is inserted and guided by fluoroscope to locate the affected disc.  A series of dilation tubes are passed over the guide wire, pushing apart the tissue and creating an opening to the vertebrae.  The guide wire is then removed.

The tubular retractor, though which the surgery will be performed, slides over the dilating tubes.  It is positioned on the bone surface and the dilating tubes are removed.  A surgical light and small camera or microscope are placed through the tube to allow the surgeon to view the disc.  The surgeon uses instruments to clear away bone and soft tissue, accessing the spinal canal.  A drill may be used to clear away bone, exposing the pinched nerve root and the herniated disc below it.  A small instrument is then passed through the retractor tube and used to check the freedom of the nerve.  The surgeon removes the herniated portion of the disc and clears the area, creating room for the nerve to move back to its normal position.  The advantage of performing a posterior cervical discectomy is that the patient is able to avoid an anterior cervical surgery, which necessitates a fusion along with dysphagia that a significant percentage of patients who undergo anterior cervical surgery tend to have.  The disadvantage of a posterior cervical surgery is that patients with foraminal stenosis in addition to the herniated disc do not a graft or cage placed into the disc space in order to increase foraminal height, or increase the space for the nerves to additionally relieve pain for the patient.

Microscopic Posterior Cervical Discectomy

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