Anterior Cervical Spine Surgery is performed to relieve compression on the nerve roots and spinal cord in the neck. This surgery is considered when the compression on the nerves is from the front and the spine is operated on from the front of the neck. Causes of nerve root and spinal cord compression : Disc prolapse - A disc prolapse (also referred to as slipped disc or disc herniation) is said to have occurred when the jelly-like central portion of the disc (nucleus pulposus) tears through the surrounding layers (annulus pulposus) and is displaced into the spinal canal, compressing the nerves extending from the spinal cord. Bony out-growths - (osteophytes) - as a result of arthritis in the spine can compress the nerve root and spinal cord. Thickening of the ligaments supporting the spinal column. Fractures and tumours, though rare, can also produce compression. Symptoms of nerve root and spinal cord compression The compression and resultant inflammation of the involved nerve root by a prolapsed disc produces pain in the neck and arms that may increase on coughing and sneezing. Numbness, the sensation of pins and needles, and muscular weakness in the arms and hands may also be present. When the prolapsed disc compresses the spinal cord (myelopathy), it can cause difficulty in walking, clumsiness (in-coordination) of the hands and problems with urinating. The presence and severity of these symptoms vary from person to person. Indications for Surgery The symptoms subside in a majority of people without surgery. Surgery is considered when, Symptoms fail to subside following a reasonable period of non-operative treatment Significant or progressive muscular weakness resulting from the nerve compression Spinal cord compression - Myelopathy - indicates the need for early surgery About the Surgery Anaesthesia: The surgery is performed under general anaesthesia, with the patient lying on the back. The procedure: The surgeon makes a 2.5 to 5 cm incision (cut) on the skin in the front of the neck. The spine is exposed by retracting (pushing to one side) the muscles and blood vessels. The prolapsed disc and/or bony osteophyte are removed using special instruments and the pressure on the nerve roots and spinal cord is relieved. After the removal of the disc, the resultant gap may be filled with bone graft (taken form the pelvic bone) or a spacer (cage) made from a plastic material called PEEK. A titanium plate with screws may also be used to provide further to the spine. A drain tube will remove the blood that collects at the surgical site. Dissolvable sutures are used to close (stitch) the skin. After the Surgery In the recovery room: Following surgery, you will be transferred to the recovery room and may feel some pain at the operated site when you wake up. You will be given pain medications, antibiotics, intravenous fluids to keep you hydrated and a urinary catheter will empty your bladder. A neck collar will be provided to keep you comfortable. When you are comfortable, you will be transferred to your room. In the ward: You will be allowed to drink sips of fluids after surgery and gradually progress to a full diet. The day after surgery, the drain tube and urinary catheter will be removed and you will be encouraged to walk. You may stay in the hospital for 1-3 days and your surgeon will decide when it is safe for you to go home. At Home: Once you are at home, it is important to stay active and take short walks at regular intervals to help reduce pain and hasten your recovery. Gradually increase the distance you walk each day but avoid strenuous activities, heavy lifting and excessive rotation or extension of your neck. You may require some help with chores and errands for the first few weeks and it is advisable to have someone to help with these activities. Notify your surgeon at once if you notice the following after surgery Excessive bleeding Redness or discharge from the wound Fever Persistent headache Weakness or numbness in the arms and legs Difficulty in passing urine