Cervical disc surgery comes in 3 main varieties of operation, with numerous procedural approaches to each. There are most disc surgery options now than ever before and trying to navigate the surgical neck pain treatment sector can be daunting and confusing for any patient.
Are you confused about undergoing surgery on a damaged disc in your neck? Do you question if surgery is even necessary for your diagnosis? If you do accept that you do require surgery, which procedure will best work to resolve your specific structural issues? These are all vital questions to consider for patients who are considering a neck operation to fix some manner of intervertebral disc problem.
This dialog explores the types and approaches of cervical spinal disc surgery. We will also provide some fundamental information that applies to all disc-targeting operations in the cervical spine to help you to make better informed treatment choices.
Cervical Herniated Disc Surgery
Herniated disc surgery is the most common type of spinal operation. Herniated discs in the neck (including bulging, prolapsed, ruptured, extruded, sequestered) are just slightly less frequently observed than lower lumbar herniated discs. Most cervical herniations occur between C4 and C7.
Surgery to “repair” or “remove” herniated discs in the neck comes in many types. Discectomy will address the herniations itself, removing part or all of the disc structure at the affected level. If the entire disc is removed, the spine must be reconstructed using either artificial disc replacement or spinal fusion. Neither option is ideal, since disc replacement often involves complications from hardware issues, while spinal fusion is one of the most invasive, unnecessary and complication-ridden of all spinal surgeries.
Some herniated discs are treated using symptomatic surgical methods that attempt to stop pain, while not addressing the herniation itself. Procedures like IDET and nucleoplasty are perfect examples of this surgical symptomatic care.
Finally, some herniated discs might rupture and leak irritating proteins that may contact nerves and create pain through a process called chemical radiculitis (chemical nerve irritation). These discs can be treated surgically as well, often with discectomy with the addition of specialized techniques, such as flushing the proteins away from the affected nerve tissue.
Cervical Degenerated Disc Surgery
Degenerative disc disease (laughably named!) is also often treated surgically. Procedures usually mimic those found in herniated intervertebral discs, with discectomy being the most common, along with either spinal fusion or disc replacement to stabilize the level.
For many years, there has been ongoing work on disc nucleus replacement operations specifically for repairing degenerated discs. However, the procedure has yet to evolve safely and repeatably, making it little more than a pipe dream for many patients. Slightly more progress has been made with injectable versions of nucleus replacement, which may be a better option anyway, with less risk and far less collateral trauma.
Cervical Disc Surgery Factsheet
Disc-targeting surgeries are the most common and the least effective of all spinal operations. Statistics for extended timeline (7 years) cures from disc surgery are abysmal. We have been warning readers of the dangers and general unnecessary nature of the majority of disc operations for decades already, but they continue to rise in number performed regardless.
Herniated discs in the neck are incredibly commonplace. So common, in fact, that most doctors no longer consider them to be abnormal at all. The vast majority of herniated discs are not pathological and will not cause any significant or enduring symptoms. Most are completely asymptomatic and those which are symptomatic tend to resolve organically and without any special care.
Degenerative disc disease (should be called disc desiccation) is completely normal, expected and universal. Treating it surgically in almost every case is a medical blunder. Of all the hundreds of thousands of disc-related procedures performed on degenerated discs yearly, we can honestly only justify less than 1% as being truly indicated.
