Cervical Myelopathy – Surgery Options

Transcript

There’s a variety of surgical approaches for treatment of spinal cord compression in the cervical spine. These can be categorized by whether motion in the neck is preserved or eliminated, and also by the approach to the neck, either anteriorly or posteriorly. The anterior options for treatment of cervical myelopathy include an anterior cervical discectomy and fusion, which is a very traditional operation that’s been around for several decades, or an anterior cervical discectomy and an artificial disc replacement, which is a relatively newer option. An anterior cervical discectomy and fusion, which is otherwise known as an ACDF, is a surgery that’s done through a small incision through the front of the neck, where we approach the disc from the front, remove the disc in its entirety, relieve the pressure on the spinal cord and the nerve roots that are leaving the spine, and then place a donor piece of bone in the space between the vertebrae where the disc used to be, and stabilize that area, usually with a plate and some screws. The disc replacement option is a similar operation, except that when the pressure on the spinal cord and nerve roots has been removed, instead of placing a donor bone and a plate and screws and eliminating the motion, we place an artificial disc that functions very similarly to a normal disc that allows the motion of that disc segment to be preserved.