Cervical Decompression

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Cervical Spine Surgery is required when there is an abnormality in the neck like a herniated or degenerative disc or injury that causes compression in the spine. Since cervical spinal cord injuries are the most severe of all spinal injuries, it may affect one or both sides of the body. Therefore, early treatment is imperative to its prognosis.

Cervical spine involves the first seven vertebral levels of the spinal column in the body. They are the very top bones which form the neck region. It consists of the bones, muscles, jointsand ligaments.

Surgical treatment of Cervical disorder involves Anterior Cervical Discectomy and Fusion (ACDF)where the damaged disc is removedand a bone graft inserted to act as a bridge between two vertebrae so that spinal fusion can occur and form a solid piece of bone. The bone graft and vertebrae are firmly fixed in place with metal screws and plates.

Bone grafts can come from different sources such as:

• Autograft Bone– bone cells taken from your own hip bones
• Allograft Bone– bone cells taken from a bone bank where people have agreed to donate their bones after they die
• Bone Graft Substitute– artificial bones made of plastic, ceramicand bioresorbable compounds

Other surgical options include Anterior Cervical Discectomy without Fusion, Posterior Approachor a Combined approach.

• Degenerative disc–a gradual degeneration of the disc between the vertebrae due to aging
• Herniated or slipped disc–when the disc breaks open or bulges out due to injury or trauma to the neck
• Spinal Stenosis–a condition when the spaces in the spine becomes narrow and the bones and other parts begin to press the spinal cord and nerves
• Rheumatoid arthritis–an auto-immune system wherein the immune system attacks the healthy joints, tissuesand muscles causing inflammation mostly in the neck
• Cervical Spondylosis–abnormal degeneration of the cartilages and bones in the neck region

• Stiffness of the neck
• Neck pain
• Swelling
• Loss of neck function
• Burning, tinglingor numbness in the neck
• Neck pain radiating to arms and shoulders

You may be interested in:Cervical Spine

• Physical examination of the cervical spine
• Electromyography (EMG)
• X-Ray
• MRI Scan
• CT Scan
• Bone assessment
• Blood tests

• A thorough examination of your cervical spine by the doctor.
• Diagnostic tests should be done as suggested.
• Inform your doctor of all your medical history along with current medication and allergies.
• The doctor will review the tests and discuss the best solution with you.
• You will be asked to stop certain medications such as blood thinners, herbal supplements etc if you currently do.
• You will be asked to stop smoking, chewing of tobacco etcif you do as nicotine prevents bone growth with a higher risk for fusion failure along with slower wound healing.
• You will also be asked to stop drinking alcohol a week before surgery and 2 weeks after surgery as it can cause bleeding problems.
• You will be asked tofast 8 – 12 hours before surgery.
• Any medications given should be taken with small sips of water.

• You will be given general anaesthesia, so this will make you fall asleep and you will not feel any pain.
• Thesurgery will take at least an hour.
• If an Autograft is to be done, your hip area will be prepared for a graft along with preparing your neck.
• An incision is made either on the left or right side of your neck.
• The muscles, organsand tissues in the neck are moved aside to have a clear view of the bony vertebrae and disc.
• With a fluoroscope, the surgeon locates the damaged disc and the areas around it are separated.
• The surgeon then makes a cut and removes the damaged disc along with the ligament and any disc material that presses the spinal nerves.
• Bone spurs pressing the nerve roots are removed and drilling is made to make more room for the nerves to exit the spinal canal.
• The open disc space is prepared for a bone graft fusion reinforced with metal plates and screws.
• An X-Ray will be done to verify the position of the graft, platesand screws.
• After checking, the surgeon places the muscles and organs back to their place.
• The incision is closedand dressing is applied.

• You will stay in the hospital for at least a night depending on your recovery and complications.
• If you had an autograft, you will feel more pain in your hip area than your neck.
• Pain medications will be administered to you.
• Drink lots of water as pain medication can result in constipation.
• You will also experience hoarseness, sore throator difficulty in swallowing, but this will heal in 1 to 4 weeks.
• You may be able toshower 1 to 4 days after surgery.
• Hot tubs, tub bathsor swimming in a pool are not allowed until you are allowed to.
• Walking a short distance initially is encouraged and a physical therapist may be recommended to help you with exercises.
• You may need to wear a cervical collar or brace.
• You may avoid sitting for long periods of time.
• You will need to avoid bending your head forward or backward.
• Do not lift anything heavier than 5 pounds.
• Follow up will be scheduled 2 weeks after surgery where examinations will be done to review recovery.

Helpful:Life After Cervical Spine Surgery

As with any surgery, Cervical spine surgery is not without risks. Some complications that could occur are:

• Failure of bone fusion
• Nerve damage
• Hardware fracture
• Migration of bone graft
• Transitional syndrome
• Difficulty swallowing
• Hoarseness of voice

The cost price may vary depending on certain factors like:

• Your medical condition
• Type of bone graft
• Type of surgery
• Location of the hospital
• Choice of hospital
• Cost of diagnostic tests
• Surgeon’s fee
• Medical treatment
• Duration of hospital stay

FAQs

Q: What is the costofcervical spine surgery in India?
A: The estimatedcost of cervical spine surgery in India 7500 USD. The cost may affect by other factors such as type of bone graft used, choice of hospitals, diagnostic tests, duration of hospital stay and surgeon's fee.

Q: Why should I consider Cervical Spine Surgery?
A: If your neck pain along with pain radiating on your shoulders and arms do not show any progress after having had conservative treatments, you must consider this surgery to give you a long-term benefit.

Q: What is the prognosis of Cervical Spine Surgery?
A: Most of the patients have a good to excellent results after the surgery. Many patients witness immediate benefits, relief and better mobility is reinforced by exercise and therapy.

Q: Which bone graft will be suitable for me?
A: This will depend on the overview of your doctor and your personal choice.

Q: What if I experience complications after surgery?
A: If at all you experience complications, they may be resolved with a second surgery or other treatments depending on the kind of complications you acquire. Complications like voice hoarseness is usually temporary.

Q: What if my bones fail to fuse?
A: Failure of the bones to fuse could be due to osteoporosis, smoking, obesity, or malnutrition. Smoking is by far the most common reason as nicotine inhibits bone-growing cells. Fusion can be compromised if you still smoke after surgery.

Q: How long does it take to recover?
A: It usuallytakes around 4 – 6 weeksproviding you have no complications whatsoever. Complete fusion and healing of the bones takes around 3 – 4 months or longer.

Q: What activity should I pursue after surgery?
A: You may start walking a few distance sometime after surgery and increase the distance gradually. Avoid lifting anything heavy and sitting for long periods of time and resume normal activities only after the doctor gives you the green signal.

Q: How does wearing a cervical brace help?
A: Cervical brace or collar will help you in providing support and limiting motion while the neck is healing. After your neck is healed, your doctor may recommend neck exercises, stretches or physical therapy for added benefit.

Q: How soon can I drive?
A: You may not be allowed to drive up to 4 weeks after surgery especially when you are under some pain medication which consists of narcotics. Discuss with your surgeon the best time to start driving.

Q: When will I be able to fly long haul?
A: This may take 4 – 6 weeks normally but depends on your recovery. Your surgeon may be the best person to recommend the time for travel. You may also want to familiarise yourself with airline policy on patients for maximum benefit.

Q:Do I need to carry a yellow fever vaccination certificate when I travel to India?
A: Yes. If you are travelling from Africa, South America, or other areas where yellow fever is found. Click Here to check the list of countries. Both adults and children need to carry the certificate.

Q: Do I need Oral Polio Vaccination Certificate?
A: Yes. All travellers from Afghanistan, Pakistan, Kenya, Ethiopia, Nigeria, Somalia, and Israel must carry an Oral Polio Vaccination (OPV) Certificate which must be taken not earlier than 6 weeks before entry. This rule applies to both adults and children.

Q:Can I get visa on arrival if I travel to India for my treatment?
A: Yes, if you are from Japan, Cambodia, Finland, Indonesia, Philippines, Luxembourg, Myanmar, New Zealand, Singapore, South Korea and, Vietnam. Travellers from Bhutan, Nepaland Maldives can enter India without a visa i.e. up to 90 days.

Q: What are the eligibility requirements for a medical visa to India?
A: If you have a valid passport and visa and are seeking medical treatment in a recognized and reputed hospital in India, then you can apply for a medical visa to India. Up to 2 attendants who are blood relatives can accompany the patient under separate attendant visas.