Degenerative cervical disc disease, also known as spondylosis often results in disc herniation. Herniation can cause compression on spinal roots and the spinal cord, resulting in pain and other symptoms. When discectomy surgery is required, part or the entire disc is removed. The space left behind is filled with grafted bone or bone substitute. In order to hold the cervical vertebrae together, metal fixation hardware can be used. All of these steps can result in problems with the surgery.
Tracheal Damage
Discectomy in the cervical spine is usually performed from the anterior, or front aspect, of the neck since it is technically easier. However, this approach combined with using sharp instruments and retraction devices can pose a risk of damage to the trachea, esophagus or major blood vessels in this area. According to Spine-Health, the risk for this type of injury is less than 0.1 percent.
Voice Box Injury
The anterior approach also can lead to damage of the recurrent laryngeal nerve that innervates the voice box for speech function. Damage to the nerve occurs when there is prolonged retraction of the tissue during surgery. The result can be hoarseness or even loss of voice that can last several months, according to Spine-Health. The rate of this complication can be up to 3 percent, according to the journal "Applied Radiology" in 2009.
Pseudarthrosis
The goal of fusion surgery is join the vertebral bones permanently so that movement between them, where the disc used to be, doesn't result in pathology. Grafted bone, either from the patient or from a donor, fills the gap left by the disc. Fixation hardware stabilizes the vertebral bones to allow them to fuse. Usually fusion is successful, but sometimes the vertebral bones do not grow together, resulting in a non-union, or pseudarthrosis. When this occurs, another surgery is needed to try to encourage the vertebral bones fuse together. The rate of non-union is as much as 10 percent, according to the journal "Applied Radiology" in 2009.
Neural Damage
Occasionally, either the fixation hardware or a surgical instrument will inadvertently cause damage to peripheral nerves, spinal roots or the spinal cord itself. Whether the neural tissue is pierced, abraded or stretched, the result can be a loss of sensory or motor function, according to the Mayfield Clinic. The amount of functional loss is proportional to degree of damage and its location. According to Spine-Health, the risk of this problem is less than 0.01 percent.
Other Dangers
Another danger of herniated cervical disc surgery includes cerebrospinal fluid leakage. Cerebrospinal fluid is the protective liquid that bathes the spinal cord and spinal roots. It is contained within a covering membrane called the dura mater. When the dura mater is nicked or thins out as a result of the surgery, cerebrospinal fluid can leak out. This usually requires surgery to correct but occurs in only about 1 percent of cases, according to SteadyHealth.com. Another complication of herniated cervical disc surgery is infection. "Applied Radiology" reports that infection can occur in up to 2.4 percent of cases. However, infection is easily treated with oral or intravenous antibiotics.
References
- Spine-Health: Spine Surgery for a Cervical Herniated Disc
- "Applied Radiology"; Diagnostic imaging of spinal fusion and complications; M. Hayeri and J. Tehranzadeh; July 2009
- Mayfield Clinic: Spinal decompression: laminectomy
- SteadyHealth.com: Surgery for herniated cervical disc
