Disc Prolapse & Anterior Cervical Discectomy
Anterior Cervical decompression is an operation designed to relieve pressure on the spinal cord caused by wear and tear changes in the cervical spine. It involves an incision over the front of the neck (right side). It is primarily designed to stop symptoms of numb, clumsy hands and difficulties in walking getting worse. Occasionally people experience marked improvement in these symptoms but I always regard that as an added bonus rather than an expectation. Following surgery about 60% of people can expect improvement in their quality of life which may be substantial or minor. In, 30% of people the disease progression is stabilised but 10% may continue to decline, possibly at a slower rate, despite adequate surgery. Overall the risks of surgery are low with less than 1% risk of neurological worsening following surgery up to and including paralysis. Some people develop neck pain following surgery but this always settles and is usually not troublesome. There is a small risk of infection, but if infection does occur it may be protracted and require long term antibiotics. The risk of a hoarse voice is 1%.
People who have wear and tear changes in their neck resulting in pressure on the spinal cord or nerve roots have a 20% risk of developing problems with other discs in the neck within ten years of their operation.
This operation has a mixed effect on neck pain. Sometimes neck pain improves, in a small number of people it will be worse, in the majority it will remain unchanged. Neck pain includes that felt over the shoulders, neck, back of the head, between the shoulder blades and sometimes over the scalp to the forehead. Many people experience a worsening or new pain between the shoulder blades. This will settle down in the vast majority of people.
Most people are admitted on the day of surgery and can expect to go home the following day. The operation usually takes an hour to perform. We get you up as soon as you are able and you are able to go home as soon as you are comfortable, usually the same day. This is generally not a very painful operation, but some people will experience some discomfort at the back of the neck, but no collar is required.
The recuperation period varies between people but on average is 6-12 weeks. During this time we encourage people to walk as much as possible, lie as much as possible but to only sit for limited periods (20-30 minutes). You should refrain from driving for 2-3 weeks, longer if you are still in pain. You will be given a set of exercises to do at home after discharge but I do not routinely recommend any further physiotherapy at this early stage. At the 2-3 month stage dependent upon your overall health and mobility you could be thinking about taking some more vigorous exercise. Walking, swimming, aerobic classes are all very suitable but please avoid contact sports, rowing machines and lifting weights! Physiotherapy can help if you are having difficulties at this stage.