Patients who are suffering from radicular pain, neck pain, motor dysfunction, and loss of sensation in the upper body may have a herniated disc in the neck. This disc rupture is likely to be compressing either a single nerve or more than one nerve in the spinal column, or even the spinal cord itself. The resulting pressure leads to nerve dysfunction, with long term compression potentially reducing of ceasing all functional activity in that nerve.
A patient who shows signs of a bulging disc is likely to be closely monitored in order to catch a disc herniation early. This can then be treated through a procedure such as a microlaminoforaminotomy to remove the cause of the compression. The full disc may be removed if it is considered necessary, although in most cases the microlaminoforaminotomy gives the surgeon the option of removing disc fragments so as to retain some of the cushioning between vertebrae. In an anterior cervical discectomy neck surgery the full disc must be removed, which may lead to problems of spinal curvature. The use of fusion to protect against this risk often leads to extra pressure on adjacent spinal segments with further cervical spine degeneration.
Avoiding Spinal Fusion
Microlaminoforaminotomy avoids the problem of having to conduct spinal fusion by only excising a tiny amount of the lamina, or back bone, in order to gain access to the disc, thereby retaining the stability of the cervical spine. The surgery also avoids cutting the muscles and ligaments lying over the posterior cervical spine making recovery quicker, and maintaining the strength, flexibility, and stability of the neck an upper back. A laminectomy, or other procedure may be required if there is evidence of disc herniation at more than one level, but this surgery is also generally more invasive, with a longer recovery time, and requires fusion in order to prevent kyphosis. If the problem in the cervical spine is broad-based, centralized, or anterior, then a posterior microlaminoforaminotomy is usually not appropriate, with anterior cervical spinal surgery performed instead. If the nerve root compression appears lateral or foraminal then a microlaminoforaminotomy is often a preferred choice for the patient.
Patients will undergo a thorough physical prior to being assessed as eligible for surgery, and a pre-operative physical on the morning they check into the hospital to ensure that there is no sign of infection which would lead to a delay in surgery. The operation is generally conducted under a local anaesthetic with optional sedative meaning that the patient is up and about very quickly after surgery is completed.
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