What kind of cervical spondylosis requires surgery?
Spinal cord type cervical spondylosis generally requires surgery, neurogenic cervical spondylosis that is ineffective with conservative treatment considers surgery, mixed type (neurogenic and spinal cord type) cervical spondylosis generally requires surgery, other types of cervical spondylosis generally consider non-surgical treatment
Is osteophyte within the scope of surgery?
If the osteophytes are compressing the nerves and spinal cord and causing symptoms, surgery can be considered to remove them, but if there is no compression, surgery is not considered.
If I am diagnosed with surgery, can I still use massage, hot compresses, cupping, etc.?
Hot compresses and cupping can be done, but massage and traction are not recommended because of the risks involved.
What are the risks of not having surgery when it is necessary?
The cervical spondylosis that requires surgery is due to the lesion compressing the nerve, spinal cord and other nervous system lesions, and it is impossible to change this lesion process by non-surgical methods such as medicine. Therefore, for future neurological function and patient quality of life, experts at home and abroad recommend early surgical treatment for patients with this condition of cervical spondylosis. Moreover, with the current medical technology progress, the risk of surgery for cervical spondylosis is getting lower and lower, and the recovery is getting faster and faster, and the main time is generally within 5 to 7 days.
Is it true that the earlier the surgery, the better the result?
It varies depending on the condition. In principle, the earlier the spinal cord type cervical spondylosis is treated, the better, while the neurogenic type cervical spondylosis can be considered for surgery if conservative treatment is ineffective.
Is there an age limit for cervical spine surgery?
With the improvement of medical treatment, doctors have discovered that patients often have “three ages”: actual age, physiological age (physiological function), and psychological age (attitude toward life). If the patient’s actual age is 80, but his physiological age is only 70 or so, and his psychological age is very young (not disconnected from social life, high demand for quality of life), then if he has cervical spondylosis, he will be very active in asking for a solution, because cervical spondylosis often affects the quality of life of the elderly, but not the life expectancy of people. Cervical spine surgery itself does not affect a person’s life span either.
Therefore, age is not an issue; the requirement for quality of life and your own physical condition determine whether you need surgery.
What conditions are contraindications to surgery?
Patients who have had a heart attack or cerebral thrombosis within six months are a contraindication to surgery and anesthesia
What are the procedures for cervical spine surgery? What kind of conditions are they suitable for?
Surgical procedures for neurogenic cervical spondylosis: 1 anterior foraminal decompression, 2 anterior transvertebral disc removal and decompression, 3 posterior Keyhole (foraminal decompression) technique, 4 anterior disc removal and intervertebral fusion and titanium plate internal fixation, 5 anterior artificial disc replacement
Spinal cord cervical spondylosis surgery: 1 anterior disc removal interbody fusion titanium plate internal fixation, 2 anterior subtotal vertebral body resection interbody implant fusion internal fixation, 3 posterior open door laminoplasty, 4 posterior canal decompression internal fixation implant fusion, 5 anterior and posterior combined decompression fixation implant fusion, 6 cervical osteotomy fixation fusion
How to choose the surgical approach? In what cases should the anterior-posterior approach be combined?
In principle, is it based on whether the nerve or spinal cord compression factor is mainly from the anterior or posterior side? It also depends on the extent to which the operator has mastered the anterior and posterior surgical techniques. If it is considered that neither the anterior nor the posterior approach can completely solve the problem, and if the operator is experienced in both anterior and posterior surgery, a combination of anterior and posterior surgery can be considered.
What are the advantages and limitations of the anterior approach?
The advantage of the anterior approach is that most of the compression caused by cervical spondylosis comes from the front, so the anterior decompression is theoretically more direct and adequate. However, this is not entirely true for a specific case.
What are the advantages and limitations of the posterior approach?
The advantages of the posterior approach are the large and clear field and the safety of the operation, but with the use of microscopic techniques, the anterior approach can also achieve a clear field. However, with the application of microscopic technology, the anterior approach can also achieve a clear field.
How to choose the bone graft material?
The principle of bone grafting material is that autologous bone is the best, the source can come from the bone block removed during decompression, but the amount of bone is often small, bone grafting from autologous iliac bone can be used, the disadvantage is to increase a trauma, the advantage is that the fusion rate of autologous bone is the highest. Allograft bone is now more widely used, the advantage is not to increase the patient trauma, the disadvantage is the need to increase the cost of surgery,, theoretically lower than the autologous bone fusion rate
What are the conditions for cervical artificial disc replacement?
Patients with cervical disc herniation with no significant preoperative instability and under 65 years of age
What kind of cervical spine surgery is suitable for minimally invasive? Under what circumstances is it not suitable?
In practice, neurogenic cervical spondylosis is suitable for minimally invasive, while spinal cord cervical spondylosis is not suitable for minimally invasive
However, theoretically, minimally invasive is not only a surgical method, not only the application of a new surgical instrument, but also a concept. Minimal trauma to the patient, quick recovery, short hospital stay, few complications and satisfactory results are themselves the embodiment of minimally invasive. Therefore, both doctors and patients need to have a proper understanding of minimally invasive surgery
What are the indications, advantages and disadvantages of the percutaneous puncture spine surgery technique, endoscopic-assisted spine surgery technique and microscope-assisted anterior cervical spine surgery?
The percutaneous puncture spine surgery technique is primarily for patients with simple disc herniation and is the type that can be retracted after preoperative assessment of radiofrequency ablation of the disc; the results for other types are uncertain.
Endoscopic cervical spine treatment is mainly for soft compressions, and for hard compressions such as bony bulges the effect of decompression is uncertain due to the influence of the microscopic equipment.
Microscope-assisted anterior cervical spine surgery mainly magnifies the surgical field, making it clearer and safer during surgical decompression, as well as more complete resection, allowing for adequate decompression of both soft and hard compressions. Therefore, for spine surgeons, microscopy will be the basic technique for performing cervical spine surgery in the future and must be mastered.
Why is shoulder pain seen more often after cervical spine surgery?
The reasons are complex, so here is a brief description of shoulder pain that was not present preoperatively and is newly present postoperatively. Generally, if it is an anterior surgery, it is often related to the intervertebral height propped up after anterior decompression and intervertebral fusion, and the nerve roots need to re-adapt to the new intervertebral height, and if it is a posterior surgery, it is often related to the posterior displacement of the nerve roots after decompression leading to increased tension and causing shoulder pain. Both of these conditions will usually improve with symptomatic treatment and will not be permanent.
What are the complications of spinal canal dilation? Can they be prevented?
The most commonly encountered conditions of spinal canal dilation are ischemia/reperfusion injury to the spinal cord, posterior displacement of the C5 nerve root, and reclosure stenosis on the open side. Preventive measures are usually available. And they are more mature.
What are the complications of bone fusion and internal fixation? Can they be prevented?
Poor bone healing, non-union of bone, loosening, fracture, displacement of internal fixation, degeneration of adjacent segments, etc. Preventive measures are available, but in some cases, they are not sure to be effective.
What should I do if my implant loosens or breaks?
Depending on the cause of loosening or fracture, the treatment plan differs in each case.
What should I do if the cervical spine bone marrow edema after cervical spine surgery compresses the nerves and causes unconsciousness below the lumbar region?
The key is to determine the cause and severity of the spinal cord edema. Hormone shock therapy is only symptomatic, and the cause of the edema determines whether or not the spinal cord compression needs to be removed by another surgery immediately.
What should I do if I have numbness and pain in my left leg and foot after anterior cervical spine surgery (no symptoms before surgery)?
Consider whether there is spinal cord edema caused by intraoperative manipulation, and observe with symptomatic treatment. Postoperative MRI can help determine the cause and prognosis.
What symptoms should be reviewed and sought as soon as possible after surgery?
Postoperative impaired limb movement, high fever, difficulty in breathing, choking on water, hoarseness, difficulty in swallowing, coughing after eating and coughing up food residue, pus flowing from the incision, non-healing, etc.
Why do cervical spine symptoms such as dizziness and hand numbness still occur after surgery?
Was the surgical decompression adequate? Was there a transient nerve shock injury during the surgery? Cervical spondylosis symptoms such as dizziness and hand numbness can occur in cases such as prolonged bed rest with postural blood pressure fluctuations.
Is cervical disc herniation after surgery a recurrence of cervical spondylosis? What kind of people are prone to it?
The situation is complicated, and it is not necessarily due to the surgery itself. Patients with long-segment surgical fixation, patients with pre-operative cervical disc degeneration, etc. can lead to cervical disc herniation after surgery.
Can I still have surgery for a herniated cervical disc?
In principle, surgery is possible, and the indications for surgery are the same as for the first surgery, where the herniated disc compresses the nerve or spinal cord and produces clinical symptoms.
In what cases do patients need second-stage surgery?
When non-surgical treatment has failed
Do I need to remove the implants implanted in the anterior cervical spine surgery? Which ones can be removed and for how long?
In general, they do not need to be removed. If clinical symptoms are to be removed, they are usually taken within 2 years after 1 year of postoperative fusion.