GOOD CANDIDATE FOR CERVICAL DISCECTOMY
People that are injured in an accident or a fall frequently injure their neck. That can create pain in the neck as well as headaches. The individual can also develop pain, tingling and numbness in the arms. People can also develop over time similar problems in the neck somewhat dependent on age. Obviously, athletes potentially accelerate the development of these problems with participation in some sports.
The study that is necessary, if the patient does not have any contraindications, is an MRI scan. The most frequent cause of the above-mentioned symptoms is a disc or discs that have been injured. The damage to the discs will be demonstrated by revealing at least disc bulges and usually disc herniation(s). A disc that is causing pain will typically be herniated but some that are interpreted as being just bulging may also cause pain in the neck and the other symptoms mentioned above. That person is frequently a candidate for the cervical discectomy procedure at the levels of the herniated discs. Dr. Watson will sit with you, assess your symptoms and discuss the best treatment options for the relief of pain.
SYMPTOMS OF CERVICAL DISCECTOMY & NEURAL DECOMPRESSION
- Head and neck pain
- Pain between the shoulders
- Pain in the arms
- Numbness in the hands and arms
COMMON CAUSES FOR NERVE COMPRESSION
Nerve compression occurs when the segmental nerves are leaving the spinal canal but are being pinched. The nerves are very sensitive to any pressure on them. If pressure is applied, it can occlude the return of venous blood back to the central circulation while arterial pressure is still maintained. The nerve will swell and the effects of the compression will result in the following:
- Tingling and/or numbness
Any combination of the above symptoms are possible with nerve compression. The result will be what is described as radicular symptoms or symptoms down the length of an extremity. Similar symptoms can occur with an inflammatory process involving an injured/herniated disc that is neovascularized or inflamed and is bathing the segmental nerve with inflammatory compounds that irritate the nerve resulting in similar symptoms down the length of an extremity.
It is necessary to have an MRI to see whether the radicular symptoms are caused by a relative compression of the nerve or is being irritated by inflammatory compounds from the herniated disc.
WHEN IS CERVICAL DISCECTOMY NECESSARY?
The cervical DND procedure is to be considered an option and not necessarily the answer for all cervical disc issues. If the patient has symptoms of neck pain, headache and arm symptoms and at least one cervical disc herniation, the cervical discectomy may be appropriate. Whether or not the procedure can be accomplished safely and successfully will depend on the appearance of the cervical spine on MRI imaging.
The procedure is not necessarily appropriate if the patient is having only minor to moderate pain and other symptoms, severe herniations or pressure on the spinal cord. The appropriateness would need to be established by a careful evaluation and physical exam as well as review of the MRI images by Dr. Watson.
CERVICAL DISCECTOMY & NEURAL DECOMPRESSION PROCEDURE
The Cervical Discectomy Neural Decompression procedure is performed in a surgery center and typically is accomplished over the course of 45 to 90 minutes depending on the anatomy of the patient, the complexity of the pathology and how many discs are problematic.
After being comfortably positioned on the operating table in the face-up position, the patient is given oxygen, connected to appropriate monitors and administered intravenous sedation to induce sleep. If considered necessary for the safety of the individual patient, a breathing tube will be inserted into the trachea after the patient goes to sleep. With the aid of fluoroscopy, needles are placed individually from the right side of the front of the neck down into each disc to be treated. This is followed by contrast to visualize the disc anatomy.
A Thulium laser is then used to treat the posterior annulus of each symptomatic herniated disc and potentially some bulging discs. The procedure places sufficient energy into the annulus to turn off the nociceptors or pain nerves, char the annulus and sometimes shrink the bulge or herniation as well as seal the blood vessels extending into the annulus. These vessels bring compounds to the disc that cause further inflammation and pain in the area. This treatment relieves much of the cervical spine pain and headaches as well as diminishing pressure on the cervical nerves leading to diminished pain, weakness, tingling or numbness down the arms. Antibiotics are then injected into each disc followed by removal of the instrumentation.
After the procedure is completed, the patient is awakened and moved to the recovery room until discharged. The average time in the recovery room is about 1 hour.
WHAT ARE THE BENEFITS OF THE CERVICAL DISCECTOMY AND NEURAL DECOMPRESSION PROCEDURE ?
The objective of cervical discectomy and neural decompression using a Thulium laser is to relieve the pain associated with a herniated disc. The benefits of the procedure include the smallest possible incisions and minimal invasiveness of small surgical instruments. Along with “turning off” the pain nociceptors in the annulus of the affected disc, decompression on the nerve roots also often occurs. These surgical achievements can significantly improve comfort and mobility without the lengthy downtime associated with traditional spinal surgery.
WHAT CAN I EXPECT AT MY CERVICAL DISCECTOMY CONSULTATION?
When you visit our Tampa office for a consultation, you will sit down with Dr. Watson to review the intake questionnaires you have completed and also the results of previous MRI scans, if available. Forms include a medical history, pain history, and a list of physical complaints. A brief examination may be performed as well. If your consultation confirms that you are a good candidate for the innovative pain relief procedure Dr. Watson has developed, you will be provided with the full details of how your particular case would be handled.
NECK SURGERY PATIENT TESTIMONIAL
“Dr. Stephen Watson was a God sent. I went in to see him with severe neck and back pain from an auto accident which I had very little range of motion in my neck w/o extreme pain. After my procedure on my neck, a discectomy and neural decompression, my pain has decreased by 80% in only 1 month. I’m confident that the pain will continue to decrease with time. I can’t wait to have my lower back done. Thank you Dr Watson for giving me back life….”
Shae T. – November 2018
HOW DO I PREPARE FOR SURGERY?
Certain medications may need to be tapered or stopped prior to the procedure. If the patient is a smoker, it is also important to understand that smoking diminishes the delivery of oxygen to the brain, heart and other tissues including the discs. For maximum safety, the smoking should cease preferably 30 days prior to the procedure to maximize the improvement in healing.
It needs to be understood that nicotine use whether by smoking, vaporization by the electronic cigarettes or even a patch can increase the level of pain the patient experiences. The patient needs to be off of aspirin products for 14 days prior to the procedure and 7 days for non-steroidal anti-inflammatories. There are other medications taken for prevention of clotting that need to be stopped as well.
None of those medications should be stopped without the physician requesting the cessation and the approval by the physician who prescribed the medication. The patient should stop all supplements up to 30 days prior to the procedure unless approved by the physician.
WHAT CAN I EXPECT AFTER CERVICAL DISCECTOMY SURGERY?
The post-procedure course varies from patient to patient. The first week will typically be the worst time although the amount of pain varies. Each patient will be given a prescription for pain medication that should last the first week. By the end of the first week, the patient will typically be feeling less pain and recognize improvement in their condition. Subsequent narcotics are not typically needed.
HOW LONG UNTIL I WILL BE ABLE TO EXERCISE AGAIN?
Cervical discectomy and neural decompression performed with the Thulium laser targets the annulus of affected discs without having to move muscles and other structures out of the way. Therefore, recovery is much faster than is typical of traditional spinal surgery. Patients should anticipate at least one week of recovery that includes minimal physical activity. After this time, light exercise may gradually resume in accordance with comfort level. Every situation is unique. Dr. Watson may approve a return to exercise gradually over several weeks after treatment.
IS CERVICAL DISCECTOMY PAINFUL?
Dr. Watson conducts cervical discectomy and neural decompression using IV sedation, which induces deep sleep. The effects of IV sedation on the central nervous system prohibit pain signals between the body and brain. Patients rest comfortably during surgery and for a short time in the recovery area until their sedation wears off. After that time, prescription pain medication is taken to control comfort.
WHAT ARE THE RISKS OF CERVICAL DISCECTOMY?
Standard surgical treatment for a herniated disc in the neck is a cervical discectomy. This procedure involves an incision in the back of the neck and the movement of para-spinal muscles to reach the facet joint of the affected vertebra. X-ray imaging is often used to confirm the correct level of the spine is being treated. During this surgical procedure, bleeding in the network of veins over the disc could obstruct visualization. These aspects of traditional cervical discectomy incur risks such as bleeding, infection, nerve root damage, spinal cord damage, and recurring pain.
Dr. Watson’s laser-assisted cervical discectomy and neural decompression procedure is much less invasive and therefore incurs much less risk. Incisions for his procedure are a mere few millimeters, only large enough to accommodate laser-powered needles to pass to the affected disc. Risks associated with this minimally invasive spinal procedure are discussed at length during the consultation.