Cervical Spine Surgery

Cervical spine surgery in India is one of the world class medical procedures offered at much affordable cost. The spinal surgery hospitals in India are equipped with excellent infrastructure and ensure best quality control, thanks to JCI accreditations. India has the best artificial disc implants with non-existent waiting period for any of these surgeries. More over, the communication is easy with English speaking doctors and medical staff. The ever present back pain due to any of the below mentioned reasons can be easily corrected with best cervical spinal surgery in India

Overview
The cervical spine is summation of seven vertebrae. Each of these vertebrae is separated by shock-absorbing discs. These discs allow the spine to be flexible and help us to move and bend.
The nerves spread out from the spinal cord and pass through openings in these vertebrae to other parts of the body. However, due to age and injury, one or more discs can degenerate leading to bulged disc or osteoarthritis of the vertebra. This leads to nerve pain and impairment of the nerves that exist between the vertebrae, leading to several problems, as shown in the image, leading to pain in the neck region. The pain can even radiate to arm, hands, shoulder and even breast. Neck pain can indicate inflammatory and degenerative spine diseases like:

• Neck pain with radiculopathy like cervical radiculopathy, cervical myelopathy
• Degenerative cervical spine disorders like intervertebral disc herniation, spondylosis, cervical spondylotic myelopathy, and cervical stenosis.
• Inflammatory cervical spine disease like rheumatoid arthritis, ankylosing spondylitis.
• Neoplastic cervical spine diseases.
• Cervical spine deformity like osteoporosis and other congenital anomalies   • Infections

Treatment options:
The treatment of cervical spine dysfunctions is mainly done through two procedures – Decompression and Fusion, which can be done through either Anterior, Posterior or Combined approach.
1. Anterior approach

• Cervical discectomy with or without fusion
• Corpectomy
• Disc arthroplasty
• Transoral approach

2. Posterior approach

• Laminectomy
• Laminectomy with fusion
• Laminoplasty
• Foraminoplasty
• Posterior discectomy
• Upper cervical fusion

3. Combined approach
Candidates
Cervical spine surgery is indicated for people who have pain that extends (radiates) from the neck to the shoulder, arms or back of scapula or breast, pain that interferes with daily activities, weakness of arms or hands, patient had physiotherapeutic and medication input, but that hasn’t helped. Procedure
The treatment of cervical spine dysfunctions is mainly done through two procedures – Decompression and Fusion. De-compression with fusion cervical spine surgery entails surgically removing the tissues which are pressing against the spinal cord or the nerves resulting in pain or other problems. The approach used for the surgery can be different depending where the tissue is being compressed. The approach used can be from the front (anterior) or back (posterior) of the spine.

There are six steps to the procedure. The operation generally takes 1 to 3 hours.

1. The patient is anesthetised and prepared for procedure. Incisions of 2-inch length are made on right side or left side of the neck. The way is paved by retracting and moving muscles, oesophagus, trachea and other structures anatomically in the way to aid in the instrumentation for the procedure.
2. The damaged disc is located with the help of a fluoroscope and a thin needle is inserted to locate the damaged disc. The surgical instruments are introduced into the space to retract the adjacent discs and spread them apart.
3. The damaged disc, which is the reason for the pain, is removed thus decompressing the nerve. Bone spurs compressing the nerves are removed and the foramen carrying the spinal nerve is enlarged with a procedure known as foraminotomy.
4. The spinal cord is decompressed by removal of disc annulus and nucleus.
5. The preparations are then done for bone graft fusion. The bone graft is properly shaped and introduced into the space between the vertebrae. The graft is kept in place with metal plates and screws.
6. Instead of fusion or graft, an artificial disc replacement into the disc space can also be done. The incisions can then be closed and dressed.

Expected Results Most patients can expect a dramatic and lasting improvement in their neck pain and pain in the arms and hands after cervical spinal surgery. Though the success rates are excellent in cervical spine surgery, it can be lower in patients who smoke, are overweight, have diabetes or other significant medical illnesses, have osteoporosis,. Good nutrition and slowly increasing activity (as recommended by your physician) in the recovery period can help achieve success.

Recovery
You are likely to experience pain and discomfort after the surgery which will be controlled with pain killers prescribed by your surgeon. You would be advised to walk the same day or the next after the surgery to prevent any clot formation. You would also be advised to do breathing exercises after the cervical surgery for better circulation of blood and decrease the risk of any lung problem. You would need to stay at the hospital for about 5-6 days after the surgery and can go back home with specific instructions to follow. Many people return to work in 3-4 weeks after the cervical surgery. You would not be allowed to do heavy work depending upon your specific condition.

Time and Cost
The total duration of hospital stay required for the procedure is 4-7 days and another week to ten days in town before you can go back. One can generally return to work or other normal activities within five to six weeks of the surgery. A total of two weeks are required for cervical spine surgery in India.