Cervical Endoscopic Discectomy (CED) for the relief of neck and arm pain
What are Cervical Discs?
Cervical discs are the structures which serve as shock absorbers between the vertebrae of the spinal column. The center of the disc, called the nucleus, is soft and springy and accepts the shock of standing, walking, running. etc. The outer ring of the disc, called the annulus, provides structure and strength to the disc. The annulus is comprised of a complex series of interwoven layers of fibrous tissues which hold the nucleus in place.
Treatments for Herniated Cervical Discs
Depending upon the results of the physical and radiologic examination and the severity of your condition, your doctor may offer you two forms of treatment. The first common treatment prescribed for neck pain caused by the herniated cervical disc is conservative therapy. Conservative therapy may consist of a period of a cervical collar, cervical traction, analgesics, chiropractic and/or physical therapy and epidural steroid injections.
However, if after therapy the pain has not been relieved, a surgical procedure may be considered. At this point the doctor can do the least invasive surgical procedure which combines the least surgical risk with the greatest opportunity for success. Surgical treatments for herniated cervical discs include:
Who Should Consider This Procedure?
This procedure is specifically designed for patients with disc problems accompanied by the following:
1. Severe neck and arm pain; with or without weakness, numbness, or tingling.
2. Certain selected cases of neck pain only.
3. Pain that has not responded to conservative treatments; i.e. cervical collar, cervical traction, analgesics, chiropractic, physical therapy and/or muscle relaxants and/or epidural steroid injections.
4. Patients with multiple cervical disc protrusions
5. Herniated cervical discs (prolapsed, ruptured, protruded, extruded, and free fragments) confirmed by radiologic studies that may include one or more of the following:
- Cat scanning
- Magnetic resonance imaging
- Enhanced CAT scan
- Myelography
- Discography
6. Patients who have small bone spurs associated with a disc protrusion are also candidates.
7. Patients with disc protrusions and bone spurs at adjacent levels benefit from the CED/ACD combination procedure.
The Surgery
The procedure is performed in the operating room in a hospital under general anesthesia. We do this procedure IN HOUSE
Postoperative Course
Most patients feel immediate relief from pain following the procedure. Walking is permitted the same day and the patients are discharged from the surgery center that afternoon.
Following your discharge, a physical therapy program near your home is recommended. Little, if any, postoperative medication is required for most patients. Normal activity can usually be resumed within one to six weeks after the surgery.
Advantages
The primary advantage of this procedure is that there is no interference with the muscles, bones, joints or manipulation of the nerves in your neck. The risks of a fusion and its long term side effects (herniation of adjacent discs. etc.) are avoided. Since the probe placement is directly into the disc and avoids the spinal canal, there is no risk of post-operative scarring of the nerves. Additionally, because the procedure is performed under intravenous sedation and local anesthesia, it is much safer for the patient than that performed under a general anesthetic. Finally, because the procedure is performed on an outpatient basis, you will be allowed to return home the day of the surgery.
Summary
Clinical results with Cervical Endoscopic Discectomy, as compared to alternative surgical procedures, have proven:
- Minimal discomfort (small puncture wound in the skin)
- No permanent paralysis or other neurological complications
- The structure of the disk still maintained (Only 10-15% is removed)
- No hospitalization
- Faster return to work and normal activity
- Because there is no hospitalization for this surgery, there is significant cost savings.
