Majority of people with pain from cervical disc disease will get better on their own over time with simple, conservative treatments. Surgery, however, may help if other treatments fail or if symptoms worsen.
Cervical disc disease is caused by an abnormality in one or more discs, the cushions that lie between the neck bones (vertebrae). When a disc is damaged due to arthritis or an unknown cause, it can lead to neck pain from inflammation or muscle spasm. In severe cases, pain and numbness can occur in the arms from pressure on the cervical nerve roots.
Cervical spine surgery is generally performed on an elective basis to treat either:
- Nerve/spinal cord impingement (decompression surgery)
- Spinal instability (fusion surgery).
The two procedures are often combined, as a decompression may de-stabilize the spine and create the need for a fusion to add stability. Spinal instrumentation (such as a small plate) can also be used to help add stability to the spinal construct.
Surgery for cervical disc disease typically involves removing the disc that is pinching the nerve or pressing on the spinal cord. This surgery is called a discectomy. Depending on where the disc is located, it can be removed through a small incision either in the front (anterior discectomy) or back (posterior discectomy) of the neck while under anesthesia.
Microdiscectomy is another similar technique which involves removing the disc through a smaller incision using a microscope or other magnifying device.
When the disc is removed, a procedure is usually performed to close the space that’s left and restore the spine to its original length. Patients have two options:
- Artificial cervical disc replacement
- Cervical fusion
Artificial disc can improve neck and arm pain as safely and effectively as cervical fusion while allowing for range of motion that is as good or better than with cervical fusion. People who get the artificial disc are often able to return to work more quickly as well. It’s also not known how the artificial discs will last over time. People who get an artificial disc can always opt for cervical fusion later. But if a patient has cervical fusion first, it’s not possible to later put an artificial disc in the same spot.