Surgical Management of Cervical Disc Herniation: A Comprehensive Guide from the WFNS Spine Committee

Cervical disc herniation is a common spinal condition affecting millions worldwide. It occurs when the soft, gelatinous center of an intervertebral disc in the cervical (neck) region of the spine protrudes through the tough outer layer, potentially pressing on nearby nerves and causing pain, numbness, or weakness in the arms and hands.

Surgical Management of Cervical Disc Herniation (WFNS Spine Committee)

by Kern Singh

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Language	:	English
File size	:	69438 KB
Screen Reader	:	Supported
Print length	:	292 pages

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Surgical intervention is often recommended to alleviate these symptoms and restore spinal stability. This comprehensive guide, authored by the renowned World Federation of Neurosurgical Societies (WFNS) Spine Committee, provides an in-depth overview of the surgical management of cervical disc herniation.

Surgical Techniques

The two main surgical approaches for cervical disc herniation are anterior cervical discectomy and fusion (ACDF) and posterior cervical laminectomy.

• Anterior Cervical Discectomy and Fusion (ACDF) involves accessing the herniated disc from the front of the neck. The surgeon removes the herniated disc material and fuses the adjacent vertebrae together to prevent future herniation.
• Posterior Cervical Laminectomy involves accessing the herniated disc from the back of the neck. The surgeon removes the lamina, a bony arch over the spinal cord, to expose the herniated disc and remove it.

The choice of surgical approach depends on factors such as the location of the herniated disc, the severity of symptoms, and the patient's overall health.

Indications for Surgery

Surgery for cervical disc herniation is typically considered when conservative treatments, such as physical therapy, medication, and injections, have failed to provide relief from symptoms.

Indications for surgical intervention include:

• Severe, persistent pain that radiates into the arms or hands
• Neurological deficits, such as numbness, weakness, or paralysis
• Progressive myelopathy, a condition that damages the spinal cord
• Failed conservative treatment

Outcomes

The outcomes of cervical disc herniation surgery are generally favorable. Most patients experience significant improvement in their symptoms following surgery.

Factors that can affect surgical outcomes include:

• The severity of the herniation
• The patient's age and overall health
• The surgical approach used
• The surgeon's experience

This comprehensive guide provides a thorough overview of the surgical management of cervical disc herniation. The WFNS Spine Committee has compiled a wealth of knowledge and expertise in this guide, making it an essential resource for neurosurgeons, spine surgeons, and healthcare professionals involved in the care of patients with this condition.

By understanding the surgical techniques, indications, and outcomes associated with cervical disc herniation surgery, healthcare professionals can make informed decisions and provide optimal care for their patients.

References

• World Federation of Neurosurgical Societies (WFNS) Spine Committee. (2020). Guidelines for the Surgical Management of Cervical Disc Herniation. World Neurosurg, 141, e1-e13.
• Hurlbert, R. J., & Amundson, B. M. (2017). Surgical Management of Cervical Disc Herniation. Neurosurgery Clinics of North America, 28(4),539-549.
• Ozuna, J., Bhatia, A., & Shaffrey, C. I. (2016). Cervical Disc Herniation Surgery: Indications, Techniques, and Outcomes. Journal of Neurological Surgery Part B: Skull Base, 77(06),412-424.