Instead of an isolated nerve, when the entire spinal cord is pressed from a slip disc, osteophyte (bony overgrowth) or ligamentous overgrowth; this condition is referred to as Cervical Myelopathy. This is a serious condition, which needs to be recognized and addressed as early as possible. Otherwise, it can result in irreversible paralysis.

These patients may complain of tingling or numbness in their hands. They may have difficulty with their balance (can be tested by trying to walk along a straight line. They may find it difficult to perform fine motor activities with their hands (like buttoning their shirt, messaging on a mobile or typing on a computer). Rarely, they may report an electrical sensation going down their body on movement of their neck. They may even report a change in their ability to control their urine or motion.

As this is an irreversible and progressive condition, the treatment for this condition is always surgical. Depending on whether the compression is from front of the neck or behind the neck, decompression can either be done from the front (ACDF or ACDR) or from behind (Cervical Laminectomy with or without fusion or Cervical Laminoplasty).

What to expect from an anterior cervical operation (ACDF or ACDR)?

The incision size is about 3-5 cm. We generally don’t use any external stitches and the scar usually gets hidden in the neck skin folds. The typical hospital stay for an ACDF or ACDR is 3-4 days. You can expect to walk the very next day after surgery. You will be pretty much independent by the time of discharge. Usually, no collar will be needed after surgery. You can expect to join back work at 4-6 weeks. The success rate for an anterior cervical operation is in the high nineties with a very small complication rate of 1-2 percent.

When a nerve root is pressed because of a slip disc or osteophytes in the neck, this condition is called cervical radiculopathy. These patients may complain of pain, tingling and numbness going down one of their arms. Rarely, they may also develop weakness of one arm.

Most of these patients improve in 3-6 weeks with the help of some medicines. But, if symptoms persist for > 6 weeks or if major weakness has developed in one of the arms, then you may need decompression of the involved nerve. This is usually done by performing an Anterior Cervical Discectomy and Fusion (ACDF) or an Anterior Cervical Disc Replacement (ACDR).