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Cervical Spine

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About “Cervical Spine”

Cervical Spine Surgery

Cervical spine surgery is needed when there is an irregularity in the neck such as a herniated or deteriorative disc or injury that leads to compression in the spine. Among all spinal cord damage, cervical spinal cord damage is the most severe. One or both sides of the body may be affected. Early treatment is therefore critical for its prognosis.

The cervical spine includes the initial seven vertebral stages of the spinal column in the body. They are the principal bones that make up the neck region. It consists of the bones, muscles, joints, and ligaments.

Surgical treatment of Cervical disorder involves Anterior Cervical Discectomy and Fusion (ACDF) 

It is the damaged disc that is eliminated. A bone implant is inserted which acts as a bridge between two vertebrae. In this case, spinal fusion can take place and create a sturdy piece of bone. The bone implant and vertebrae are strongly secured in place with metal screws and plates.

The bone implant is done from various sources such as:

  • Autograft Bone – This bone cell is taken from the patient’s own hip bones.
  • Allograft Bone – This bone cell is taken from a donor or bone bank where a person donates their bone after death.
  • Bone Graft Substitute – Artificial bones made of plastic, ceramic and bioresorbable compounds. Other surgical options include Anterior Cervical Discectomy without Fusion, Posterior Approach, or a Combined approach.

Causes of Cervical Spine Disorders

  • Degenerative disc – A gradual decline of the disc between the vertebrae because of aging.
  • Herniated or slipped disc – A disc that breaks open or bulges out after being injured or traumatized.
  • Spinal Stenosis – A condition when the spaces in the spine become narrow and the bones and other parts begin to press on the spinal cord and nerves.
  • Rheumatoid Arthritis – An auto-immune condition wherein the immune system attacks the healthy joints, tissues, and muscles causing inflammation mainly in the neck.
  • Cervical Spondylosis – Abnormal degeneration of the cartilage and bones in the neck region.

Symptoms of Cervical Spine Disorders

  • Stiffness of the neck.
  • Neck pain.
  • Swelling.
  • Loss of neck function.
  • Burning tingling or numbness in the neck.
  • Neck pain radiating to arms and shoulders.

Diagnosis and Tests

  • Physical examination of the cervical spine.
  • Electromyography (EMG)
  • X-Ray
  • CT Scan
  • MRI Scan
  • Bone assessment
  • Blood tests

Procedure

Before Surgery:

  • A thorough examination of your cervical spine by the doctor.
  • Diagnostic tests should be done as suggested.
  • Tell your doctor about your medical history, as well as your current medications and allergies.
  • The doctor will observe the tests and suggest the most appropriate solution for you.
  • You will be asked to stop certain medications such as blood thinners, herbal supplements, etc. If you currently do.
  • You will be advised not to smoke, chew tobacco, etc. If you avoid it, nicotine inhibits bone growth, which makes fusions more likely to fail, and it slows the healing of wounds.
  • You will be asked to stop drinking alcohol a week before surgery and 2 weeks after surgery as it can cause bleeding problems.
  • Before surgery, you will be asked to fast for 8-12 hours.
  • Any medication you’re given should be taken with small sips of water.

During Surgery:

  • You will be given general anesthesia, so this will make you fall asleep and you will not feel any pain.
  • The surgery will take at least an hour.
  • If an Autograft is to be done, your hip area will be prepared for graft along with organizing your neck.
  • An incision is made either on the left or right side of your neck.
  • The neck’s muscles, organs, and tissues are moved aside to have a clear view of the bony vertebrae and disc.
  • By using a fluoroscope, the surgeon finds the damaged disc and separates the affected areas.
  • The surgeon then cuts and removes the damaged disc along with the ligament and any disc material that presses the spinal nerves.
  • Bone spurs pressing on the nerve roots are removed and drilling is made into the spinal canal.
  • Open disc space is prepared for a bone graft fusion bolstered with metal plates and screws.
  • An X-ray is done to confirm the location of the graft, plates, and screws.
  • After checking, the surgeon places the muscles and organs back in their place.
  • The cut is closed and a bandage is used.

After Surgery:

  • Depending on your recovery and complications, you will stay in the hospital for at least a night.
  • If you have autograft, you will experience more pain in your hip region than in your neck.
  • Pain medications will be administered to you.
  • Drinking lots of water as pain medication can result in constipation.
  • A sore throat, hoarseness, or difficulty swallowing will also occur, but these symptoms will disappear in one to four weeks.
  • It may take 1 to 4 days after surgery for you to be able to shower.
  • Hot tubs, tub baths, or swimming in a pool are not allowed until you are allowed to.
  • Walking a short distance is encouraged and a physical therapist may be recommended to help you with exercises.
  • You may need to wear a cervical collar or brace.
  • You are not allowed to sit for a long time.
  • You are not allowed to bend your head forward or backward.
  • Do not lift anything which is more than 5 pounds.
  • Following surgery, there will be a follow-up appointment 2 weeks later to review recovery.

Risks and Complications

Every type of surgery has some complications and risks. Cervical spine surgery also has some complications. Some are given below:

  • Failure of bone fusion.
  • Nerve damage.
  • Hardware fracture.
  • Migrations of bone graft.
  • Transitional syndrome.
  • Difficulty swallowing.
  • Hoarseness of voice.

Factors affecting the cost of Cervical Spine Surgery

The cost of surgery depends on several factors that include:

  • Your medical condition.
  • Type of bone graft.
  • Type of surgery.
  • Location of the hospital.
  • Choice of the hospital.
  • Cost of diagnostic tests.
  • Surgeon’s fee.
  • Medical treatment.
  • Duration of hospital stay.

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