The nerves that control the neck, arms and upper body are located in the cervical spine. There are seven cervical vertebrae that make up the spine and include eight pairs of spinal nerves. When a disc protrudes and places pressure on a spinal nerve in the neck, cervical discectomy surgery may be indicated. Cervical spine surgery can have complications.
Spinal Cord and Nerve Injury
The cervical spine nerves are the nerves that coordinate the ability to breath, move our arms and neck, and control sensory perception of the upper body. The most serious complication of cervical spine surgery is paralysis. This is a rare complication, but because injury to the spinal cord is up in the neck, patients can have complete paralysis from the neck down. The amount of paralysis can vary depending on the area of damage, according to the Maryland Spine Center.
Frequently, cervical discectomies are done from the front of the neck. This is called an Anterior Cervical Discectomy and Fusion, or ACDF. The muscles of the neck, the esophagus and vasculature are retracted to one side in order to visualize the spine. Overly vigorous retraction, inadvertent cutting or swelling in the neck postoperatively can affect the recurrent laryngeal nerve causing hoarseness and difficulty swallowing. According to the Mayfield Clinic, this is rarely a permanent condition, but may take a month or so to resolve.
Implant Migration
In 1 to 2 percent of patients, bone graft migration can occur, according to the Mayfield Clinic. Bone grafts are used to replace the removed disc in order to prevent instability of the spine. These bone grafts are held in place with metal plates that are screwed into the vertebrae. Occasionally, the screws break or become loose, and the bone graft moves. This typically happens in the very early postoperative phase, notes the University of Maryland Spine Center. Implant migration will require reoperation.
Chronic Pain
In many patients, the disc has been pressing on the nerve for so long that they have developed permanent pain and weakness. Persistent pain is a complication of cervical spine surgery and one of the most common, according to the Maryland Spine Center. Compression on the nerve from the disc may be prolonged and subsequently, the nerve becomes unresponsive to surgical decompression, according to the Mayfield Clinic.
Pseudoarthrosis
Pseudoarthrosis is a term that is used when the vertebrae do not fuse. The number one cause of failed fusions is smoking. Non-fused vertebrae are unstable and allow motion between them. This motion creates pain, and eventually can break the metal plates and screws that have been placed. Pseudoarthrosis requires reoperation.
