Microendoscopic Discectomy – Neck Surgery
A discectomy is a surgical procedure to remove a herniated or degenerative disc in the spine. This procedure can be performed in the lumbar and/or cervical spine and is often either preceded by another surgical procedure, such as a laminectomy, or followed by fusion – in some cases all three are considered necessary. Whilst conventional open techniques used to remove a herniated disc involve either cutting the muscles and ligaments in the spine, or removing large portions of the lamina or back bone, minimal access microendoscopic cervical discectomy is performed via endoscopic technique, reducing the degree of trauma to the neck region.
Neck Surgery Candidates
Patients with radicular pain, weakness, numbness, loss of fine motor skill and strength, and paraesthesias in the arms and neck are candidates for his kind of surgery where the symptoms are a result of a herniated or degenerative disc. Conservative treatment for neck pain will most likely be given in the first instance, and the majority of patients find that the use of NSAIDs, analgesics, complementary therapies, and physical therapies alleviate their symptoms to a manageable degree, or that the pain resolves over time. For those who do not achieve relief with conservative treatment the option of a discectomy will likely be discussed with the consulting physician.
Delaying Neck Surgery
Some patients will undergo a discectomy fairly promptly after the diagnosis of disc herniation as this can reduce the risk of permanent nerve damage if there is evidence, through x-rays, MRIs or other scans, that the nerve is being severely impinged by the ruptured disc. Patients who experience weakness, poor circulation, loss of sensation, and severe neck pain are more likely to require surgery quickly to prevent lasting nerve damage. If surgery is delayed then permanent loss of sensation and function may occur in that specific nerve pathway.
Minimally Invasive Surgery
The procedure is achieved from the back (posterior) of the spine by removing a portion of the lamina, which is the bone that covers the spinal cord. More than one disc may be removed during a discectomy, with several small holes made at different points of the lamina in order to provide the surgeon access to the specific discs. In conventional surgery the patient would have a large incision made in the neck and retractors would be used to open up the area for the surgeon to have excellent visual access to all the structures int eh cervical spine. Minimal access microendoscopic discectomy relies on the use of an endoscope to provide visual access during the procedure, as the incision is very small. By removing smaller portions of the lamina rather than conducting a full laminectomy, minimally invasive discectomy allows the surgeon to forego the necessity of fusion after disc removal as the intervertebral height can be maintained by the mainly intact cervical spinal structures without the risk of spinal curvature, or kyphosis.
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