Herniation(prolapse) describes an abnormality of the intervertebral disc that is also known as a “slipped,” “ruptured” or “bulging” disc. This process occurs when the inner part (nucleus pulposus) of the intervertebral disc bulges out. It usually happens through the outer, more fibrous layer that surround the disc (annulus fibrosis).
The narrowing of the spinal canal is called spinal stenosis. This can happen as a result of the degeneration of spine and subsequent hypertrophy of the facet joints, spinal ligaments, bony end plates, and the intervertebral discs.
Tumours may be Primary or secondary. It may be extradural,Intradural extramedullary or Intramedullary tumours.
The most common are bony tumours, meningioms, schwanommas, ependymomas, Astrocytomas
Post traumatic conditions like locked facets, perched facets, listhesis can happen which will compress the spinal cord.
All these conditions causes variable symptoms depending of level and degree of compression and involvement of spinal cord and exiting nerve roots.
Symptoms may vary from
Mainly depends on patients symptoms and examination signs and severity of nerve and spinal cord compression due to various etiologies described above.
When a disc herniates or begins to degenerate and collapse, there is less room for the nerve roots (and sometimes the spinal cord) to function, which can be a source of chronic pain, tingling, numbness, and/or weakness radiating from the neck into the arm. Clearing away the damaged disc and inserting an implant aims to relieve pressure on any compressed nerves to give them space to heal and function normally. If the spinal cord was previously compressed, relieving pressure on it may help resolve or prevent progression of other symptoms, such as trouble with coordination, walking, and/or bladder or bowel control.
The surgery has 2 parts:
The key goals of cervical artificial disc replacement surgery are to relieve nerve compression while also maintaining motion at the repaired spinal level.
By replacing the damaged disc with an artificial disc, natural biomechanics can be more closely retained throughout the cervical spine when the neck moves.
A cervical foraminotomy is an operation done from the back of the neck to relieve pressure on one or more spinal nerves. It involves carefully removing a small portion of bone and joint which overlie the spinal nerve, as well as any soft tissue which may also be causing compression
Anterior cervical corpectomy and fusion (ACCF) is a treatment option for degenerative cervical pathologies with spinal cord compression and traumatic subaxial cercical injuries. The cervical spine is accessed by an anterior approach. After discectomy, the middle part of the vertebral body is resected. The defect is filled with a graft/implant to maintain height and stability followed by anterior plating.
Cervical laminoplasty is a non-fusion, decompression procedure for cervical spondylotic myelopathy . It is most commonly indicated for patients with multiple level stenosis who have preserved lordotic alignment and minimal to no axial neck pain related to spondylosis. Expansion of the laminar arch can allow for direct and indirect decompression of the spinal canal.