A number of cervical spine conditions may warrant surgery, including spinal stenosis, herniated discs or a spinal fracture. In general, surgery is only indicated as a last resort, if conservative treatments have failed to relieve a person's symptoms. They may also be indicated if the spine is unstable, or following a trauma. Most cervical spinal surgeries are performed under general anesthesia, and require a short hospital stay.
Anterior Cervical Discectomy
An anterior cervical discectomy, or ACD, involves removing part of an intervertebral disc (the cushions between the vertebrae) through an incision in the front of the neck. An ACD is performed to relieve pressure on spinal nerves. The American Association of Neurological Surgeons reports that bone spurs may also be removed during this procedure. According to the University of Southern California (USC) Center for Spinal Surgery, an ACD is one of the most common neck surgeries today. An ACD is sometimes combined with a cervical fusion, in which two or more vertebrae are grafted together with bone fragments and/or metal plates. This is called an anterior cervical discectomy with fusion, or ACDF.
Anterior Cervical Corpectomy and Fusion
An anterior cervical corpectomy (ACCF) is similar in approach to an ACD, but the procedure itself is more extensive. The USC Center for Spinal Surgery reports that an ACCF is performed to remove larger bone spurs, and may require the removal of an entire vertebrae and/or intervertebral disc. After removal, that portion of the spine is fused together for stability with bone, grafting materials or metal plates.
Disc Arthroplasty
A disc arthroplasty involves replacing a damaged intervertebral disc with an artificial disc. In theory, this could be performed during an anterior discectomy in place of fusing the bones together. The American Association of Neuroscience Nurses (AANN) cites this as an up and coming cervical spinal surgery; however, the USC Center for Spinal Surgery reports that the FDA has only approved artificial disc surgery for the lower back. Cervical procedures are currently under review.
Posterior Miscrodiscectomy
During a posterior microdiscectomy, a portion of the herniated disc is removed through a smaller incision in the back of the neck. Nerve roots may be moved and freed during the procedure as well. According to the AANN, a posterior discectomy may or may not require a spinal fusion. This procedure is generally performed only if the herniated disc bulges to one side or the other, according to the American Association of Neurological Surgeons.
Posterior Foraminotomy
A posterior foraminotomy is similar in approach to a posterior microdiscectomy; however, the foraminotomy also involves enlarging the hole through which nerve roots pass. Bone spurs may also be removed during this procedure. The AANN reports that fusion of the vertebra is usually not required during a posterior foraminotomy.
Posterior Cervical Laminectomy
A posterior cervical laminectomy is similar to a posterior foraminotomy in that portions of the vertebral bones are removed to make room for spinal nerves. However, a laminectomy also involves removing part of the lamina, which is the bony part of the spine visible on a person's back. According to the American Academy of Neurological Surgeons, bone spurs and portions of the intervertebral discs may also be removed during this procedure.
