Category: Neck Surgery | Author: Stefano Sinicropi
Posterior cervical decompression surgery, also known as a microdiscectomy operation, is a procedure that involves removing part of a damaged disc that is compressing nearby structures. The posterior approach means the surgeon comes in from the back of the person’s neck, and the procedure has some benefits and drawbacks compared to a spinal fusion operation. Below, we explore those advantages and how the procedure is performed.
Advantages and Disadvantages of Cervical Microdiscectomy
The main advantage of using a posterior microdiscectomy approach is that the surgeon does not need to also perform a spinal fusion after the damaged disc is removed, which leads to decreased recovery time. One downfall of the technique is that because of the way the surgeon addresses the spinal canal, the disc space cannot be jacked open with a bone graft to add space to the region. Also, although patients benefit from the majority of the damaged disc remaining in place, there’s a higher likelihood (3-5%) that another herniation will occur in the future with this approach. However, most surgeons prefer the posterior approach to the anterior approach because it is considered a more reliable and definitive procedure, and it is less demanding on the patient and surgeon.
There are also some risks involved in the procedure. Some of the more common risks and complications that occur include nerve damage, infection, bleeding, dural leaks or pain. That being said, the complication rate for a microdiscectomy operation is very low, so even though these are considered “common” complications, they rarely occur.
How is Posterior Cervical Decompression Surgery Performed?
Here’s a quick overview of what happens during a posterior cervical decompression operation:
- The patient is given general anesthesia and is asleep for the operation. The patient is lying on their stomach on the operating table so the surgeon can approach the spine from the back of your neck.
- The surgeon makes a small incision on the midline of the back of the neck, and they carefully navigate around the paraspinal muscles to access the troubled disc.
- Part of the facet joint is removed, and using an operating microscope to better visualize the site, the part of the damaged disc that has shifted is carefully removed.
- Spinal stability is ensured once the disc is removed, then the surgeon carefully removes their devices and returns the paraspinal muscles to their original location. The incision site is then closed, and the patient is sent off to a recovery ward.
Patients can typically be discharged the same day as surgery, and walking and activity is encouraged so long as the activity is tolerable. You should refrain from strenuous activity until you’ve been cleared by the surgeon. You will begin a physical therapy routine shortly thereafter, and you should expect to be cleared by your physician for full activity at your follow up appointment, which is typically scheduled 4-6 weeks after the operation.