Information about your procedure: 

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The intervertebral disc is the structure between the vertebrae (bones of the spine), which acts as a spacer and a shock absorber.

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Following your consultation with your spinal surgeon, you have been diagnosed with having a cervical disc protrusion resulting in nerve root compression and arm pain. Occasionally, the disc protrusion can also cause spinal cord compression resulting in weakness in your legs.

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In general, if a patient’s arm pain due to a cervical disc protrusion is going to get better, then it will do so in about 6–12 weeks.

However, if the symptoms have not resolved following conservative measures (physiotherapy, medication or injections), surgery may be necessary.

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About the procedure

The operation is carried out under general anaesthetic, through an incision in the front of the neck. After other structures have been moved aside, the disc material is removed and the implant, containing bone graft, is placed in the space created. The implant is stabilised in the disc space by a small blade.

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Risks and complications

Risks include the following:

• Damage to the nerve root and the outer lining which surrounds the nerve roots (dura). This is reported in < 5% of cases. This could result in neck or arm pain, weakness or numbness, leaking from the wound, headaches or, very rarely, meningitis.

• Bleeding in the wound and swelling around the windpipe (laryngeal oedema), which could result in difficulty breathing or swallowing. You must inform your consultant if you are taking blood-thinning tablets, such as warfarin, aspirin or clopidogrel.

• Deep wound infections may occur in < 1% of cases. These can be difficult to treat with antibiotics alone and sometimes patients require more surgery.

• Bony non-union. This can occur in up to 5%.

• Ongoing neck and arm pain.

• Implant movement can occur in up to 2%, with 1% requiring re-operation.

• Damage to the trachea (windpipe) or oesophagus (food pipe). This is reported in less than 1% of cases.

• The nerve that supplies the vocal cords sometimes does not function after surgery because of retraction during the procedure. This could cause temporary or rarely some permanent hoarseness of the voice. Retraction of the oesophagus can produce temporary difficulty with swallowing.

• Very rarely but and in extreme circumstances there may be damage to the spinal cord with paralysis and loss of control to the bladder and bowel. This can occur through bleeding into the spinal canal after surgery. If this was to occur, every effort would be made to reverse the situation by returning to theatre to wash out the haematoma. Sometimes, however, paralysis can occur as a result of damage or reduction of the blood supply of the nerves or spinal cord and this is unfortunately not reversible.

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