WHAT IS IT?
This operation is performed on the upper spine to relieve pressure on one or more nerve roots or on the spinal cord. The term is derived from the words anterior (front), cervical (neck), discectomy (removal of disc), and fusion (joining the vertebrae with a bone graft).
WHAT IS DONE?
A ruptured intervertebral disc or bone spur can put pressure on one or more nerve roots (often called nerve root compression) or on the spinal cord, causing pain and other symptoms in the neck and arms. Debilitating pain and/or neurological deficit are often reasons for performing this type of operation.
THE OPERATION
The surgery is performed with the patient lying on his back. A small incision is made in the front for the neck, to one side. The affected disc is removed, thereby decompressing the nerve root. A cage and/or bone (known as allograft or donor bone) with a titanium plate may be used. Bone marrow could be aspirated from your cervical vertebra or hip. This will be placed in the disc space, where it will begin to fuse the vertebrae it lies between. This process takes four to six months. The neck incision is often closed with internal dissolving sutures. The outer layer of skin is held together with a plastic surgery technique using Steri-Strips (small pieces of tape). These are to stay on for about ten to fourteen days after surgery.
RISKS:
Certain risks must be considered with any operation. Although every precaution will be taken to avoid complications, surgical risks include infection, excessive bleeding (hemorrhage), adverse reaction to anesthesia, stroke, injury to the trachea, carotid artery or esophagus, injury to the laryngeal nerve which causes hoarseness and may or may not be permanent, injury to the involved nerve root(s) or the spinal cord, both of which can cause varying types of degrees of paralysis.
The State of Texas requires full disclosure and consent for a spine operation. The risks on your consent form for the surgery include pain, numbness or clumsiness, impaired muscle function, incontinence or impotence, unstable spine, recurrence or continuation of the condition that required the operation, and injury to major blood vessels.
A reduced rate of spine fusion probably occurs in smokers. If you are a smoker, it is recommended that you stop.
Anti-inflammatories can also slow down or prevent spinal fusions so we recommend you do not use them.
After a spinal fusion there is added stress on adjacent joints that can on occasion lead to deterioration that can make additional treatment and potentially more surgery necessary in the future.
PHYSICAL ACTIVITY:
You may move about in bed and rest in any comfortable position when you have recovered from anesthesia. Walking may begin within several hours. The easiest way for you to get out of bed is to raise the head of the bed as far as it will go, and then swing your legs to the floor.
Two cervical collars will be ordered for you after surgery. The soft collar for resting and eating, a hard collar is to be worn when you are up and about walking or in a car. The collar is designed to remind you to avoid quick turns of the head or extremes or awkward positions to you neck and to aid in the healing of your fusion. These are to be worn for approximately two months.
Gradually increase the amount of walking and sitting you do each day. Since you may experience cervical muscular discomfort, spend a large portion of your day reclining. No leaving your house for approximately two weeks. If discomfort occurs, change positions frequently, heating pad or ice to the back of your neck and in between your shoulder blades 3 to 4 time per day can help.
DISCHARGE:
The average hospital say is one overnight, depending on the extent of the surgery. This will be determined by your progress and by the amount of comfort and help available to you at home.
HOME RECOVERY
Daily walking is the best exercise. Only around the house for the first two weeks. Try to increase your activity gradually, setting a pace that avoids fatigue or severe pain. You may climb stairs when you feel able. No heavy lifting.
Sexual relations may be resumed during the recovery period, but activities that strain the neck or cause pain should be avoided.
“Listen” to your body. Discomfort is normal while you gradually return to normal activity, but pain is a signal to stop what you are doing and proceed more slowly.
MEDICATION:
You will need pain medication once you leave the hospital. If you are under the care of a pain management doctor or have been on narcotics from another MD, it is important you let them know of your upcoming surgery and discuss your pain management postop-op.
A tolerance to certain medications can often affect your anesthesia and post-op pain control. Pain medications are ideally handled by 1 physician. Please discuss this with the doctor or nurse.
You should gradually use less pain medication while recovering at home. Increase the amount of time between taking pills, then reduce the number taken each time. A certain amount of discomfort and pain in the neck and arms(s) can be expected until the inflammation and nerve sensitivity have subsided. Heat, ice, massage, and short rest periods will also help relieve pain.
NUTRITION:
A well-balanced diet is necessary for proper healing. Include foods from each basic food group: dairy products, meat, vegetables, and fruits. Since you will be less active during recuperation, avoid rich, heavy food and those high in calories but low in nutrients. Calcium is important to aid in the fusion of your spine (dairy products, calcium enriched Tums or Rolaids or calcium supplements). Constipation will be treated with a well-balanced diet and laxatives as needed.
Call the office (210-614-2453) soon after discharge and make an appointment to see the nurse approximately two to three weeks after surgery.
Be patient with yourself and focus on your progress. A positive attitude will speed your return to normal daily activity.
Please ask our office and nurse questions if you are concerned about activities, which are safe for you.
