What Positioning Is Used for Anterior Cervical Discectomy During Surgery?

Ruptured or herniated discs are a common cause of severe neck and shoulder pain. While there are a variety of nonsurgical interventions that can help treat or relieve this condition, anterior cervical discectomy is also commonly performed to correct a herniated disk in the cervical spine. With this procedure, as with all procedures, correct surgical positioning is important to ensure the surgeon can access the herniated disc in the patient's neck.

Herniated Discs

• The cervical vertebrae are the seven uppermost vertebrae of the spine just beneath the skull. In between each pair of vertebrae is a disc consisting of a tough outer layer around a jelly-like center. If the tough, fibrous outer ring of a spinal disc weakens or degenerates, some of the soft central portion of the disc can squeeze its way out and compress the sensitive nerve root, causing severe pain in the neck, shoulders or arms.

Treatments

• Physicians often treat cervical pain with medications, physical therapy or other noninvasive techniques. If there is no improvement, however, or the patient's condition continues to deteriorate, anterior cervical discectomy and fusion may be necessary.

Surgical Positioning

• It's essential during all surgeries that the patient be properly positioned to give the surgeon sufficient access while avoiding stress or strain on the patient's joints and limbs. Some common surgical positions are the lithotomy position (patient lies on their back with their knees bent and spread wide using stirrups); the prone position (patient lies face down on a flat table); and the supine position (patient lies face up on a flat table). Anterior cervical discectomy is performed with the patient in the supine position.

Procedure

• First, general anesthesia is administered and a breathing tube is placed. The surgeon makes an incision in the front of your neck, moves your esophagus and trachea toward the middle and your carotid artery and jugular vein out of the way toward the side. The herniated disk is removed completely through the incision. Often (although not always), the disc is replaced with a bone graft, either from a cadaver or from your own body, so the two vertebrae above and below it will fuse.

After Surgery

• After the surgery, a physical or occupational therapist will typically work with you before your discharge from the hospital. You may be given a neck brace or a cervical collar to help reduce the strain on your neck until it's fully healed. Generally the long-term results are quite positive, although as always, if you have any questions about the supine position or whether anterior cervical discectomy is right for you, it's best to consult with your doctor.