Microsurgery for Cervical Disc Herniation

What is Cervical Disc Herniation?

Anatomy of the Cervical Spine

The cervical spine consists of seven vertebrae (C1-C7) with intervertebral discs between C2-C3 through C7-T1. These discs provide cushioning and allow neck movement. The most commonly affected levels are C5-C6 and C6-C7, where the greatest mechanical stress occurs.

Symptoms of Cervical Disc Herniation

Cervical Radiculopathy (Nerve Root Compression)

• Sharp, shooting pain radiating down the arm
• Numbness or tingling in the arm, hand, or fingers
• Weakness in specific arm or hand muscles
• Pain worsening with neck movement
• Symptoms often following a specific nerve distribution pattern

Cervical Myelopathy (Spinal Cord Compression)

• Difficulty with fine motor tasks (buttoning, writing)
• Balance and coordination problems
• Weakness in arms and/or legs
• Gait disturbance
• Numbness in hands or feet
• Bladder or bowel dysfunction (severe cases)

Diagnosis

Accurate diagnosis requires comprehensive evaluation:

• Clinical Examination: Detailed neurological assessment of strength, sensation, and reflexes
• MRI Cervical Spine: Gold standard for visualizing disc herniation and neural compression
• CT Scan: Evaluates bone structures and calcified disc material
• X-rays: Assess spinal alignment and stability
• Electrodiagnostic Studies: EMG/NCS to evaluate nerve function when needed

Surgical Treatment Options

Anterior Cervical Discectomy and Fusion (ACDF)

The most common surgical approach for cervical disc herniation:

• Approach: Small incision in the front of the neck
• Procedure: Disc completely removed, bone graft or cage inserted, plate may be added
• Advantages: Direct access to disc, excellent decompression, high fusion rates
• Recovery: Usually same-day or overnight stay

Cervical Disc Replacement (Artificial Disc)

Motion-preserving alternative to fusion in select patients:

• Approach: Similar anterior approach as ACDF
• Procedure: Disc replaced with artificial device that maintains motion
• Advantages: Preserves neck motion at treated level, may reduce adjacent level stress
• Candidates: Selected patients without significant arthritis or instability

Posterior Cervical Foraminotomy

Minimally invasive approach for lateral disc herniations:

• Approach: Small incision in the back of the neck
• Procedure: Bone removed to decompress nerve without removing entire disc
• Advantages: Preserves disc and motion, no fusion needed
• Candidates: Patients with foraminal stenosis or lateral disc herniations

Microsurgical Technique Advantages

• Magnification: Operating microscope provides superior visualization
• Precision: Delicate structures protected during decompression
• Minimal Tissue Trauma: Less muscle damage and scarring
• Better Outcomes: Lower complication rates with experienced surgeons
• Faster Recovery: Earlier return to activities

Recovery After Surgery

Immediately Post-Surgery

• Most patients go home same day or next morning
• Arm pain typically improves immediately
• Soft collar may be recommended for comfort
• Mild throat discomfort common after anterior surgery (resolves in days)

First Few Weeks

• Avoid heavy lifting and strenuous activities
• Gentle walking encouraged
• Follow-up appointment at 2 weeks
• Gradual return to light activities

Long-term Recovery

• Return to desk work: 2-4 weeks
• Return to physical work: 6-12 weeks
• Physical therapy may begin at 4-6 weeks
• Full fusion (if ACDF): 3-6 months
• Complete recovery: 3-6 months

Success Rates

Microsurgical treatment of cervical disc herniation has excellent outcomes:

• 90-95% of patients experience significant improvement in arm pain
• Myelopathy symptoms stabilize or improve in most patients
• ACDF fusion rates exceed 95% with modern techniques
• Patient satisfaction rates are consistently high

Why Choose Prof. Dr. Salim Şentürk?

• Extensive experience in cervical spine microsurgery
• Proficiency in all surgical approaches (anterior, posterior, minimally invasive)
• Advanced microsurgical techniques and equipment
• Personalized treatment planning for each patient
• Comprehensive pre and post-operative care

Frequently Asked Questions

Which surgical approach is best for me?

The optimal approach depends on the location and type of herniation, presence of myelopathy, number of levels involved, and individual patient factors. Prof. Dr. Salim Şentürk will recommend the most appropriate technique based on your specific situation.

Will I lose neck motion after ACDF?

Single-level ACDF results in minimal noticeable motion loss as other levels compensate. Multi-level fusion may have more impact on overall neck mobility, though most patients adapt well.

How long does the surgery take?

Single-level ACDF typically takes 1-2 hours. Additional levels or more complex procedures may take longer.

What are the risks of cervical spine surgery?

While serious complications are rare with experienced surgeons, potential risks include infection, bleeding, nerve injury, hoarseness, difficulty swallowing, and non-fusion. These risks are minimized through meticulous surgical technique.

When can I drive after surgery?

Most patients can resume driving at 2-4 weeks when they can comfortably turn their head to check blind spots and are off narcotic pain medications.