Discectomy and Laminotomy

To relieve nerve pressure and neck pain, surgery usually involves a partial cervical disc removal or discectomy. This surgery is usually done from the front of the neck (called an anterior discectomy). In addition, the surgeon may need to access the problem disc by removing a portion of the bone covering the nerve. This procedure is called a laminotomy and is usually done from the back of the neck (posterior laminotomy). Fortunately, these procedures can often be done utilizing minimally invasive techniques. Minimally invasive surgery does not require large incisions, but instead uses smaller cuts and tiny specialized instruments and devices such as a microscope and endoscope during the operation.

The disc may be removed from the back of the neck (posterior approach) or from the front (anterior approach). Generally, surgeons favor the anterior approach for most cervical disc herniations.

·         Anterior approach – may be favored if there is any disc space collapse, as the approach allows the surgeon to "jack open" the disc space and place a bone graft to keep it open. This procedure opens up the foramen, which gives the exiting nerve root more room

·         Posterior approach – may be favored for a large soft disc that is lateral (to the side of) the canal

When Discectomy and Laminotomy  prove unsuccessful, fusion surgery of the vertebra is often recomended. The resulting elimination of the natural range of motion often resulted in further damage to adjacent discs. This cervical disc surgery is called anterior cervical discectomy and fusion (ACDF).

Over the past 15 years a breakthrough treatment for cervical Degenerative Disc Disease has been developed in Europe known as Artificial Disc Replacement (ADR) or Disc Arthroplasty. A disc prosthesis is implanted between the vertebra after removing the core of the damaged disc. Disc space is restored and range of motion is maintained limiting further damage. Cervical Disc Replacement can also be used to eliminate damage in adjacent discs where previous spinal fusion exists.

Disc Replacement or Disc Arthroplasty, as compared to other orthopedic disciplines, is the next evolutionary step in spine surgery. Disc Replacement surgery is now commercially available in Europe and many other countries. FDA trials are underway and should be concluded within the next few years, although many Americans have been going to Germany, to avoid Spinal Fusion and get their Artificial Disc Replacement surgery for years.    

Artificial Disc Replacement | Degenerative Disc Disease | Discectomy and Laminotomy | Discectomy with Fusion | Foraminal Stenosis | Cervical DDD

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