Anterior Cervical Discectomy
Risks of an Anterior Cervical Discectomy
The usual surgical risks are present with an anterior cervical discectomy, including loss of blood, risk of infection, problematic reaction to the anaesthesia, thrombophlebitis, and problems with respiratory regulation. Nandoe Tewarie (2007) found an incidence of 10.5% for all post-operative complications from this neck surgery, with several minor complications such as urinary tract infections (3.7%). General risks of spinal surgery are also to be considered. These include the potential for nerves or blood vessels in the cervical spine to be knocked or cut accidentally during the procedure with resulting effects such as radicular pain, loss of sensation, and potentially paralysis. Progressive neurological loss has been observed in less than one percent of patients undergoing this surgery (Nandoe Tewarie, 2007). Stroke is another possibility, but, as with the other problems, the risks are very low. Getting the patient up and moving as soon a possible after surgery will help reduce the risk of thrombophlebitis, as will the use of blood thinning medication and pressure stockings during surgery.
Discussing the Risks
Patients should be informed of the risks prior to making their final decision about surgery and should take them into account when weighing up the potential benefits of the procedure. Damage to the spinal cord itself is also a rare, but present, possibility. Nearly ninety percent of anterior cervical discectomy procedures go smoothly and have no deleterious effects (Nandoe Tewarie, 2007).
How the Vocal Cords are Affected
As this particularly surgery is in the area where the vocal cords and larynx lie there is a small chance that damage to the voice can occur. Nandoe Tewarie (2007) conducted an analysis of hundreds of patients undergoing this surgery and found that 2.2% had a temporary hoarseness post-operation. Patients may find an initially huskiness to their speech when first coming round from the surgery and the area may feel tender when they talk, particularly if they try to raise their voice. This usually wears off after a few days at most and speech returns to normal. In some cases this effect may be more permanent, with long-lasting damage to the recurrent laryngeal nerve having occurred.
Patients may feel some residual pain after the surgery due to inflammation of the previously compressed nerve. This pain should lessen as the nerve heals allowing patients to reduce the frequency and strength of any medication such as analgesics or anti-inflammatories they are using. Patients may find that moist heat and gentle movement help relieve these short-term symptoms. Residual numbness may last a little longer after surgery as the pinched nerve regains proper function.
Anterior cervical discectomy is the standard procedure for those suffering severe symptoms due to a herniated or compressed disc. It is highly effective in the short term at relieving a patient’s symptoms, but unfortunately does not prevent further spinal degeneration, particularly in conditions such as spinal stenosis, cervical spondylolysis, or cervical spondylolisthesis.
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Last Updated: 10/10/2010