A novel, minimally invasive technique to correct cervical radiculopathy

Degenerative discs in the neck often cause patients to suffer from neck pain and nerve-related pain that shoots into the arm and/or hand. These symptoms can be confused with a shoulder problem or carpal tunnel syndrome.

Although the symptoms are similar, for many of these patients, physical exam reveals that their pain is actually secondary to degenerative disk disease, or a herniated disk in their neck.   In some cases, x-ray, MRI or electromyography are employed to confirm the diagnosis.

These patients are often surprised to learn that it has been their neck all along, rather than their shoulder or arm, which has caused their pain.  Many respond to initial conservative treatment, which consists of physical therapy or chiropractic manipulation, steroid injections and pain medicines; but when these fail, surgical intervention is indicated.

The classic procedure is an anterior cervical discectomy and fusion, which has proved very effective for many patients, depending on where their disk is herniated and the nature of their nerve compression.  Other times, an extensive posterior cervical decompression and fusion is performed.

A newer, novel technique available to many of these patients is the minimally invasive posterior cervical facet fusion, a smaller operation with fewer risks and less chance for complications.  During the procedure, the surgeon makes two incisions about a half inch in length, to insert the device into the facet joints of the spine, which takes the pressure off the nerve and stabilizes that segment.

This type of posterior cervical decompression and fusion can be done in about 30 minutes, either on an out-patient basis, or when appropriate, with a one-night stay in the hospital.  Most patients go home wearing a cervical collar for a few weeks, with some limitations on lifting, but are back to full activity within about six weeks.  The success rate is on the order of 80 to 85 percent for reduction of arm and hand pain.

The newer procedure doesn’t completely supplant the cervical discectomy and fusion, but can replace it in some patients, and is a good adjunct to it in the proper setting, again depending upon the patient’s presentation.

Dr. Bryan Fox joined the team at the Sports Medicine & Orthopaedic Center to establish an adult spinal surgery arm of the practice at Obici Hospital. He is an expert in minimally invasive spine surgery techniques, having performed over a thousand spinal surgeries and taught several types of highly effective and innovative spine surgery procedures. smoc-pt.com