Cervical spine surgery might be needed by some patients who undergo degenerative changes or arthritis, in the neck, leading to pain and disc herniation. Most patients experience pain radiating down the arms due to a disc bulge or herniation. A surgery known as discectomy is performed to remove the piece of disc or the entire disc that is putting excess pressure on the nerves or spinal cord. This would provide relief from symptoms associated with arm numbness, tingling, pain or weakness. Surgery is typically recommended when non-invasive treatments fail to provide relief.
There are different types of procedures that can be used for cervical spine disc problems. An anterior fusion is a procedure that helps stabilize the vertebrae of the spine and reduces the chances of slippage of discs. A bone graft is taken from iliac crest (hip) and it is inserted between the vertebrae, from the area where the disc has been removed. Further, the surgeon inserts plate and screws to stabilize the neck. Surgery will last approximately 2 to 4 hours. It is followed by one night stay at hospital. In a posterior approach, the incision is made in the back of the neck for the fusion to stabilize the spine.
Spine surgery in India is a safe and effective treatment for cervical disc herniation. The top spine surgeon of the country are internationally trained and renowned specialists with vast experience. They work at world-class hospitals and ensure complete treatment and recovery after the surgery. These hospitals offer the latest surgical technique to enable faster and healthier recovery, with lesser risk of complications. However, spine surgery is a major operation and patients are given a set of preoperative instruction to ensure successful treatment. This includes:
Quit smoking: Ptaients who smoke are advised to quit smoking or using tobacco products at
least one month prior to the spine surgery. These products comprise nicotine in some form, which hinders bone fusion and healing. Because of this nicotine that may affect the healing and bone fusion, smoking products such as Nicorette gum or nicotine patches must also be discontinued one month before the surgery. The surgeon will help discuss and help the patient stop smoking before the operation.
For medications prior to surgery: Patients are encouraged to share the details of the medicines they are using. The surgeon may recommend stopping certain medicines that may affect the healing or increase the risk of post-surgery complications. This includes drugs such as non-steroidal anti-inflammatory medicines 7-10 days prior to surgery. Those who take aspirin or any anticoagulants may also need to stop taking their dose as per the recommendation of health care specialist. Also, any herbal supplements and certain vitamins must be restricted a week or 10 days before the surgery, as they tend to thin the blood and cause bleeding problems.
Diabetic patients are advised not to take any oral hypoglycemic agents and insulin products on the morning of surgery. Any and all diuretics must also be avoided on the morning of surgery, unless the patient has congestive heart failure. The surgeon will advise or prescribe the dosage, if needed, as per the patient’s health condition requirements.
There are certain tasks that should be followed before surgery to ensure better results and success. Patients are advised to go over the postoperative exercises and restrictions which typically includes no bending, twisting, and lifting heavy weight (greater than 5 pounds). They must arrange somebody, a family member or friend, to drive them home after the surgery and check on them through the first couple of weeks after the surgery.
The length of time for recovery will depend on the type of surgery and technique used. If an international patient is undergoing surgery at a foreign location, they must arrange for stay in a hotel as per the recommended duration of time.
The tests and medical evaluation in the pre-operative phase:
The medical team will schedule a series of pre-admission evaluation to ensure that the patient is healthy enough for the surgery. The evaluation may include some or all of the following tests:
- Medical history of the patient
- Physical examination by the surgeon
- Anesthesia review
- Laboratory tests: blood and urine tests
- Radiology tests including spine X-rays, MRI, CT Scan or myelogram
After the surgery, the patient will have to undergo physical therapy. It may start at the hospital only and then continue in an outpatient clinic after the discharge. However, the therapist suggests some exercises that can be performed at home to build muscle strength.
Some patient may need a neck collar/brace or halo brace before the surgery also. Patients may check with their insurance company also to figure out if they cover the cost for durable medical equipment (DME), including a walker or commode. This will help them prepare for any co-pay or buy equipment that may not be covered by insurance.
Patients can also take help from the physical therapist and hospital coordinator for arranging the equipment and ensure the insurance coverage. The medical equipment must be ordered a few days before the discharge or during the preparatory phase only so that they can be timely delivered to home. The list of required medical equipment may include:
- Tub seat, bench or chair to use in the bathtub or shower
- Elevated commode or toilet seat extender
- Long-handled reacher