Discectomy: Anterior Cervical

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  • Cervical disc disease with:
  • Persistence of pain despite adequate conservative treatment
  • Increasing and significant neurologic deficit
  • Cervical myelopathy
  • Central disc herniation
  • Multilevel disc disease
  • Cervical instability
  • Morbid obesity
  • Intraoperative x-ray equipment
  • Anterior cervical discectomy retractor system
  • Smooth tipped retractor blades
  • Operating microscope
  • High-speed microdrill with angled handpiece
  • Small Kerrison rongeur
  • Microscissors
  • 1-2 mm foot-plated bone punch
  • Cervical spine: 7 vertebrae with 8 nerve roots named for the pedicle they exit above.
  • Intervertebral disc is formed by the inner soft nucleus pulposus and an outer annulus fibrosus and is connected to the anterior longitudinal ligament, posterior longitudinal ligament, and the endplates of the vertebrae above and below.
  • The neural elements are arranged consistently throughout the spine.
    • The most cephalad roots lie laterally, the most caudal roots centrally.
    • The motor roots are ventral to the sensory roots at all levels.
    • The dorsal root ganglion lies at the level of the intervertebral foramen.

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • Monitor neurologic function.
  • Discharge when ambulatory (usually on same day).
  • Return to work: clerical work when comfortable, manual labor 6 weeks.
  • Immobilization unnecessary, soft collar for postoperative pain optional.
  • Physical therapy is usually not necessary.
  • There are no long-term restrictions.
  • Neurologic injury
  • Vascular injury
  • Persistent symptoms
  • Infection
  • Dural tear

Long-term results are not yet available and we do not have sufficient clinical experience with this technique, but it appears to have promising outcomes on short-term and intermediate follow-up.

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