In the event of a larger, possibly bony (indurated) and/or on both sides expanding herniated disc of the cervical spinal column, a microsurgical operation from the front (ventral discectomy) is necessary.

Operating technique

Under full narcosis, a circa three centimeter long incision is made on the front side of the neck (similar to a thyroid gland operation). The carotid artery, the larynx, and the esophagus are held to the side. The surgeon then completely removes the disc under microscopic observation with corresponding fine instruments, including the protruding tissue.

In addition, he removes bony disc areas as well as bony vertebral outgrowths (osteophyte). Afterwards, he places an implant (a so-called cage) made of carbon, plastic, or titanium in a cleared out area around the disc. The implant ensures that the vertebrae maintain the proper distance from and position to one another.

When operating on multiple discs, or by a noticeable loosening in the cervical spinal region (sliding vertebrae), an additional plating may be required in order to stabilize the affected vertebrae. For this, the doctor sets a thin metal plate made out of titanium from the front onto the spinal column and fastens it to the vertebrae with tiny screws. In the course of the next few weeks, the affected vertebrae grow together. Afterwards, the cervical spinal column is once again able to support a load.

Indication

• extensive or partially bony herniated discs of the cervical spinal column

• narrowing of the vertebral canal (spinal canal stenosis) of the cervical spinal column with spinal cord compression

• narrowing of the nerve canal (foramen stenosis) with compression of the spinal nerves

• instability (vertebral slippage) of the cervical spinal column

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