Cervical disc herniation

DID YOU KNOW THAT...

The main symptoms of cervical disc herniation is pain in the upper limbs, shoulder as well as numbing and headaches. If an MRI examination reveals considerable lesions and significant stenosis of the spinal canal due to degenerative changes, a surgical procedure is a treatment of choice. If cervical disc herniation with considerable stenosis of the spinal canal is left untreated, the spinal cord may become permanently damaged, which will lead to considerable disability.

Benefits:

  • The use of modern implants with a spine stabilizing function (Zero P) allows patients to return to normal activity and work at a faster pace. The implants also reduce the risk of interbody graft dislocation and the recurrence of problems.
  • In young patients we use artificial discs that can move so the spine retains its mobility.
  • For some types of the disease (lesions located at the side of the spine) we use methods which do not require implants, which makes the procedure much less invasive.
  • After fast and minimally invasive surgical procedures patients can quickly return to work, and day-to-day activities are no longer painful.
  • Minimally invasive procedures also carry a smaller risk of complications associated with damage to nerve roots and wound healing.
  • Importantly, after procedures performed with the aid of the microscope or endoscope wounds measure from 5 mm to 15 mm, which translates into a much smaller trauma to the body. For the whole body a smaller trauma means a smaller impact on the immune system, a lower decrease in immunity and fewer general complications.
  • Minimally invasive procedures require a shorter hospital stay.
  • After our procedures you will be able to get up and move independently one hour after the surgery.

Indications and contraindications

  Indications:

 

Absolute indications – requiring fast surgical treatment:

  • paresis/plegia of the lower limb, urinary incontinence, objects falling out of hands, symptoms of myelopathy (damage to the spinal cord).

Relative indications – depending on pain severity and its impact on day-to-day activities:

  • limb fatigue, pain between shoulder blades, headaches,
  • if a large narrowing of the spinal canal is visible on an MRI scan and causes acute pain, real recovery within a few weeks is rather unlikely. In such cases the patients may undergo a surgery directly after diagnosis is made.
  Contraindications:
  • medications which significantly decrease blood coagulation,
  • serious conditions of other system when general anaesthesia cannot be used.

Treatment options:

Anterior cervical discectomy and fusion

This is the most common treatment method. The incision is made on the front of the neck and is about 2 cm long. The whole disc (including the herniation and osteophytes) is removed. An implant is inserted into the evacuated disc space between the adjacent vertebrae. We have a wide variety of implants to choose from. The implant is always adjusted to a given patient and his/her condition.

Anterior foraminotomy

The procedure is applied when the lesions are located laterally in the spinal canal, directly above the root at the front.

Posterior foraminotomy

Surgical approach and skin incision is on the back of the neck. The procedure is applied when the intervertebral space is narrowed at the back due to degenerative changes, or when a large sequester (disc fragment) is herniated laterally.

Eligibility for the procedure:

  • The patient’s eligibility is evaluated on the basis of the whole clinical picture.
  • Diagnostic imaging is necessary: the standard test is a 1.5 or 3-tesla MRI scan. If there are absolute contraindications for an MRI scan (strong claustrophobia, metal implants, others), the patient’s eligibility may be evaluated on the basis of an ‘open’, low-field MRI or computed tomography.
  • For large degenerative lesions a computed tomography examination is recommended in addition to an MRI scan.
  • If there are any doubts as to the diagnosis, an EMG test is performed as it enables precise determination of the level where the pain and other symptoms originate.

Before the procedure:

The basic laboratory tests include blood type and Rh factor, complete blood count, basic biochemistry tests (sodium, potassium, urea, creatinine, glucose), coagulation parameters (APTT, INR), ECG, a general chest x-ray (for patients over 40 or with a history of pulmonological problems). Additional tests or consultations with specialists may be required, depending on the patient’s condition, the underlying disease and other medical conditions (such as a thyroid profile test, urinalysis, consultation with a cardiologist). The meeting with the anaesthetist takes place a few days before the procedure if the neurosurgeon so recommended. Otherwise, the meeting takes place on the day of the procedure, during the admission process.
Please bring to the hospital only the necessary items, such as medical records, neurosurgeon’s consultation documents with the eligibility evaluation, imaging test results (MRI, CT, x-ray) on CDs with descriptions, laboratory test results, routine medications, toiletries, towel, socks, pyjamas and footwear as well as a change of clothes. Please do not bring any jewellery and other valuables. In each hospital room there is a wardrobe and a cupboard for your personal belongings (in two-person rooms each patient has his/her own wardrobe and cupboard).
The final evaluation of your eligibility for the procedure is done on the day of the procedure. You will be asked to give written consent to the surgical procedure and general anaesthesia (you can download samples from our site). You take your blood pressure medications, heart medications and hormonal medications if you take them on a regular basis.

Procedure:

The surgery is performed under general anaesthesia. The standard procedure is performed using the surgical microscope and a high-speed surgical drill. This increases the safety of the procedure while at the same time minimizing invasiveness. The surgical procedure is always discussed with the patient before the surgery. Minimally invasive procedures are always the preferred option.  Usually the procedure lasts from 60 to 120 minutes, depending on the extent of the intervention and the procedure used. Subcuticular suturing is used.

After the procedure:

After the procedure you wake up at the recovery room next to the operating theatre. Following your full awakening from anaesthesia you will be transferred either to your room or the recovery room (depending on your condition and the course of anaesthesia/procedure).
After 2 hours we make the first attempt to mobilise you (with a nurse’s or a doctor’s assistance). On the day of the procedure you may walk around your room and go to the bathroom. Activity is slightly limited. On the day after the procedure you get up in the morning and increase your activity level. Before midday you should be able to walk in the corridor or the balcony. During that time you will receive advice on post-operative rehabilitation from a qualified physiotherapist. You will be discharged in the afternoon, after a medical examination.
While at home you should avoid effort for 2 to 3 weeks. In the first week after the surgery you should schedule a follow-up appointment to check your wound. The next visit is scheduled 3 weeks after the procedure to evaluate preliminary treatment outcomes. During the whole post-operative period you can call your doctor directly.

Our specialistsNeurosurgery

poznaj naszych specjalistów >

Price listNeurosurgery

przejdź do cennika >

Make an appointment

+48 61 62 33 111

Wielkopolskie Centrum Medyczne
Sp z o.o. S.K.A

st. Bolesława Krzywoustego 114
61-144 Poznań, POLAND

Hospital hours:

Mon-Fri 8:00 – 20:00
Sat 8:00 – 16:00

Contact us to arrange a visit or to learn more!

Call us! +48 61 62 33 111

Write to us

By sending a message, you agree that the St. Adalbert's Hospital would contact with you by phone or e-mail and you declare that you have read the Privacy Policy.


close button Powered by Medidesk
For more information
leave your number,
I'll call you back.
Please leave your number.
We'll call you back.!