Cervical Disc Surgery in Sharjah

What is cervical disc surgery?

Cervical disc surgery covers the operations that free the nerves in the neck, the cervical spine, where seven small vertebrae are separated by discs. With age or injury a disc can bulge, split or flatten, and the bone next to it can grow spurs. Both narrow the openings where nerve roots leave for the arm, and sometimes the central canal that carries the spinal cord itself.

Surprisingly for most patients, the usual route to a neck disc is through the front of the neck. The surgeon passes between the windpipe and gullet on one side and the carotid artery on the other, gently moving these structures aside rather than cutting through muscle, and reaches the disc directly. At Dar Al Kamal Hospital, Sharjah, the choice of operation is made by the consultant neurosurgeon after matching your symptoms, examination and scan to one specific level of the neck.

Who needs it

Cervical disc surgery is considered for two groups of people. The first has arm pain, numbness or weakness from a single compressed nerve root that stays severe after a proper period of non-surgical care, or weakness in the arm that is getting worse. The second has pressure on the spinal cord, called cervical myelopathy, which shows as clumsy hands, trouble with buttons or handwriting, dropping things, or unsteady walking. For myelopathy the main aim of surgery is to stop the cord from being squeezed further, so an earlier decision is often advised. Neck pain on its own, and the non-surgical care that comes first, are covered on the neck pain assessment page.

When surgery is the right step, the surgeon weighs these options:

• Anterior cervical discectomy and fusion (ACDF) removes the whole disc and any spurs from the front, then fills the space with a spacer so the two vertebrae grow together. A small plate may hold them steady; see spinal fusion.
• Cervical disc replacement removes the disc from the front and fits a moving artificial disc, keeping motion at that level. It suits selected younger patients with healthy joints behind the disc.
• Posterior foraminotomy works from the back of the neck to widen the opening around one nerve root, keeping the disc in place.
• Laminectomy or laminoplasty from the back gives the spinal cord more room where several levels are narrowed.

The decision rests on whether the nerve root or the cord is affected, how many levels are involved, where the pressure sits, and the alignment of your neck on X-ray.

What happens

Cervical disc surgery is carried out under general anaesthetic; see Anaesthesiology. For the front approach you lie on your back with the head slightly tilted, and the incision is usually a short horizontal line in a natural skin crease, which tends to heal discreetly. An X-ray during the operation confirms the correct level before any disc is removed.

The surgeon may use magnification to clear the disc and spurs away from the nerve and cord, then places the spacer or artificial disc. For the back approaches you lie face down and the incision runs along the middle of the neck. Where specialised monitoring of the nerves during surgery is appropriate for your case, the team discusses how it is arranged beforehand. You are helped to sit up and walk once the anaesthetic wears off.

Preparing for it

Before surgery you have blood tests, a pre-operative assessment and, often, up-to-date X-rays of the neck. Tell the team about every medicine you take, especially blood thinners, diabetes medicines and anti-inflammatory tablets. Stopping smoking helps the bones knit after fusion.

Practise getting in and out of bed by rolling onto your side first, and set up a chair with good head support. Soft foods and cool drinks are easier in the first days after a front approach, so stock them at home. If you drive for work, sit long hours at a screen, or have a long-haul flight planned, tell the surgeon so your return can be timed with you. For fasting patients, plan the timing around Ramadan early.

Afterwards

Arm pain is often the first symptom to ease, while numbness and hand strength can improve more gradually as the nerve recovers. A mild sore throat and a hoarse voice are common for a short time after a front approach. Walking is encouraged from the first day, and a rehabilitation programme for neck and shoulder strength is arranged through your care pathway. Your surgeon gives you a timeline covering driving, screen work and lifting. In the Sharjah heat, keep the wound dry and drink water regularly.

Contact the hospital if the wound becomes red or starts to leak, if you develop a fever, or if arm pain or weakness returns. **Go to the emergency department straight away if you have any difficulty breathing or the front of your neck swells quickly, as this can mean bleeding under the wound.**

Cost and insurance

Most UAE insurance plans cover cervical disc surgery when it is medically needed, and it almost always requires pre-approval supported by your MRI, examination findings and a record of the treatment already tried. An artificial disc or plate may be assessed separately. Starting early keeps your date on track; Dar Al Kamal Hospital, Sharjah can help you confirm your cover on 06 599 7777.