Back Surgery for Cervical Spinal Stenosis
Cervical Spinal Surgery – A Delicate Procedure
The presence of the thyroid gland, the trachea, oesophagus, and major veins and arteries makes the neck a complex site on which to conduct surgery. Several nerves in the area are responsible for innervating a multitude of different tissues and surgery risks causing nerve trauma leading to problems with the voice, breathing, swallowing, and other functions. Conversely, cervical spinal stenosis that remains unaddressed may cause permanent nerve damage in itself, with a delicate balance struck between conservative management and urgent intervention for patients. Cervical spinal stenosis with myelopathy is usually only treatable with surgical decompression although radiculopathy often responds well to conservative treatments such as NSAIDs, activity modification, and specific exercises for pinched neck nerves. Myelopathy often progresses slowly with mild symptoms initially and then a sudden increase in difficulties with coordination and mobility. Surgery is then, for almost all patients, the only way in which symptoms might be relieved.
Cervical Spinal Stenosis Surgery Types
Back surgery for cervical spinal stenosis may take the form of a relatively minor microforaminotomy, or a more extensive laminectomy, discectomy, and spinal fusion procedure. Techniques to achieve substantial decompression of the spine with minimal access and tissue trauma have improved considerably over recent years, with many patients able to undergo an operation in a clinic setting and return home on the same day. More traditional, open back surgery procedures often take a lot longer, require general anaesthetic, and involve a few days in the hospital for monitoring and initial rehabilitation. The usual surgical risks apply in all cases, with infection (both deep and shallow), thrombophlebitis, nerve and spinal cord trauma, and blood loss possible. Patients may also suffer from respiratory or cardiovascular complications, particularly if having a general anaesthetic where predisposing medical conditions are present. Failed back surgery syndrome is also a possibility, and may be due to scar tissue formation, accidental trauma during the procedure itself, or possible misdiagnosis and operation at the incorrect vertebral level.
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