Best Cervical Discectomy Surgery in India

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Cervical discectomy is surgery to remove one or more discs from the neck. The disc is the pad that separates the neck vertebrae; ectomy means to take out. Usually a discectomy is combined with a fusion of the two vertebrae that are separated by the disc. In some cases, this procedure is done without a fusion. A cervical discectomy surgery without a fusion may be suggested for younger patients between 20 and 45 years old who have symptoms due to a herniated disc.

Different Approaches to treat Cervical Discectomy Spine Problem:-

Anterior Approach: The anterior approach allows the surgeon to have direct access to the degenerated disc without having to manipulate any nerve roots. Better correction of the collapsed disc to its native height can also be achieved by having a better leverage point to open the disc space. This can also help in restoring lordosis to the lumbar spine and to decrease fatigue of the surrounding posterior spinal muscles. No anterior or posterior muscle dissection is required to gain access to the front of the spine (unless the anterior approach is done in combination with a posterior approach for instrumentation). Avoiding injury to the recurrent laryngeal nerve (especially on the right side) and superior laryngeal nerve is a major consideration in the anterior approach to the lower cervical spine. The sympathetic trunk is situated in close proximity to the medial border of the longus colli at the C6 level (the longus colli diverge laterally, whereas the sympathetic trunk converges medially). The damage leads to the development of Horner's syndrome with its associated ptosis, meiosis, and anhydrosis. Awareness of the regional anatomy of the sympathetic trunk may help in identifying and preserving this important structure while performing anterior cervical discectomy surgery or during exposure of the transverse foramen or uncovertebral joint at the lower cervical levels. 

Posterior Approach: While anterior cervical discectomy or anterior corpectomy are excellent options for younger patients and those with inadequate cervical lordotic curve, dorsal procedures can often be used in patients with a well-maintained cervical lordotic curve. This can include patients with multilevel cervical spondylosis as well as those with OPLL. Cervical laminectomy and decompression can often be augmented by lateral mass fusion to correct instability or to prevent loss of future sagittal alignment. Laminoplasty is also offered as an alternative to lateral mass fusion. In patients undergoing posterior decompression surgery, there should be evidence of preoperative cervical lordosis of at least 10° and less than 7 mm of anterior-posterior OPLL for indirect decompression to be successful. The most significant advantage of a posterior approach is that it avoids the potential soft-tissue complications of the anterior approach. Furthermore, there is no risk of graft extrusion, but there is a decreased incidence of postoperative pseudarthrosis. In cervical discectomy surgery it has additionally been proposed that OPLL is associated with a "dynamic myelopathy" in which the cervical spinal cord is progressively injured by repeated movement of the cord parenchyma over the ossified ventral mass. Arthrodesis and simple collar immobilization in these patients may serve to "stiffen" the cervical spine and decrease deleterious motion.

Minimally invasive cervical disc replacement surgery

Minimally invasive cervical disc replacement surgery entails inserting an artificial cervical disc between two cervical vertebrae after the inter- vertebral disc has been surgically removed in the process of decompressing the spinal cord or a nerve root. The intent of the device in cervical discectomy surgery is to preserve motion at the disc space. It is an alternative to the use of bone grafts, plates and screws in pursuit of a fusion following procedures such a disc removal, which necessarily eliminates motion at the operated disc space in the neck.

Cervical disc replacement surgery is most typically done for patients with cervical disc herniations that have not responded to non-surgical treatment options and are significantly affecting the individuals' quality of life and ability to function.

The advantages of minimally invasive cervical disc replacement surgery:

·         Maintaining normal neck motion

·         Reducing degeneration of adjacent segments of the cervical spine

·         Eliminating the need for a bone graft

·         Early postoperative neck motion

·         Faster return to normal activity

·         Postoperative neck braces are not required for disc replacement operations.

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