Recent News and Articles on the Keywords: prolapsed disc + disc + neck  Related to the article below (Last Update: 8/5/2008)

Me and my operation: prolapsed neck disc

 The NHS undertakes almost 2,000 operations to remove and replace neck discs each year. Known as anterior cervical discectomy and fusion, the operation to relieve pain and prevent possible paralysis carries the risk of worsening the condition and causing paralysis.
Here, 37-year-old radiographer Katie Reavley, who lives with her husband and three children in Gosforth, near Newcastle upon Tyne, describes her neck disc prolapse operation, while her surgeon explains the procedure.

The patient:
My problems started almost four years ago. I was lifting my five-month-old son out of his cot when I felt a terrific pain in my neck.

It had me flat on my back for three days, and even though the pain lessened, a dull ache in my neck would start whenever I felt tired.

Then, a couple of weeks before Christmas, my foot went completely numb and freezing cold. It was a very odd sensation, and I just hoped it would go away.

Instead it got worse. Within two months the ice-cold feeling went all the way up my left side from my foot to my armpit. I couldn't tell hot water from cold on that side in the shower, and if I scratched myself, I had no sensation.

I was too frightened to go to the doctor because I thought it might be multiple sclerosis. But finally, in February, I consulted my GP.

She did some tests and referred me to Newcastle's Nuffield Hospital, where I work as a radiographer.

I decided to go privately because there was such a long NHS wait, and I was seen within a week by a neurologist who arranged an MRI scan of my brain and the top third of the spine.

It showed I had a prolapsed - or displaced - disc at the bottom of my neck. I was getting strange sensations because the disc was pressing on my spinal cord.

The neurologist referred me to Christopher Gerber at Newcastle General Hospital, who told me the only way to resolve the problem was to operate. Without it, he felt the disc would keep slipping and might cause damage to my spinal cord or even paralysis.

So in March, I was admitted to Newcastle General. As soon as I came around, I knew the surgery had been successful because I could feel my left side again.

From the recovery room, I was put on a high-dependency unit - which is routine for this operation - where a nurse was with me all the time, checking my blood pressure every ten minutes. I was in hospital for a week.

I could have gone home sooner, but was advised to stay as long as possible, because it's hard to recuperate at home with children. When I was discharged, I wore a soft collar, mainly to remind the children not to knock me. But after a month, I was lifting them up again and, providing I was careful, I was fine.

The doctor Christopher Gerber, consultant neurosurgeon at Newcastle General Hospital, says: If Katie hadn't had this operation, the chances are she would have ended up incontinent, paralysed and in a wheelchair.

Normally you see this in patients in their 40s and 50s. It's caused by wear and tear, which causes the disc to slip and press on the nerve.

This causes unremitting neck and arm pain and sometimes weakness in the hand. We don't know why Katie got it at such a young age. Some people are more predisposed to it than others.

The object of the surgery is to remove the faulty disc - taking the pressure off the spinal cord - and insert in its place a titanium disc packed with synthetic bone which will fuse with the vertebrae on either side within two months.

The first incision is made on the right side of the patient's neck. Then, holding back the skin edges with retractors, we can see the platysma muscle. This is the vertical strip of muscle which stands out from your neck when you grimace. I make a horizontal cut of about 2-3cm through this.

Now, we see the carotid artery and the internal jugular vein on the patient's right side and - in the middle - the windpipe with the gullet behind it.

We gently pull the carotid artery and internal jugular vein to the patient's right and hold that with a retractor, and we pull the gullet and windpipe to the left and hold them with another retractor so we have the front of the spine and the disc exposed.

Our next task is to ensure we operate on the correct disc. To do this, we place a needle in the disc as a landmark and a radiographer X-rays the top part of the spine.

Providing the X-rays confirm we're at the right junction, we proceed with the second stage of the operation. For this, I look through an operating microscope to remove the damaged disc.

As soon as it's out, we select the right size of titanium cage for the space left by the disc. Before fitting it, we pack it with a mixture of bovine bone granules and a couple of drops of the patient's blood.

Over a period of two months, this mixture will fuse with the patient's vertebrae. The next step is to ease the cage into the vertebrae, which we do by screwing a little handle onto the cage and gently tapping it into position - again checking it's in place on X-ray.

That done, we unscrew the cage handle, remove the retractors and use a heated electric current to seal any bleeding.

Next we close the platysma muscle, putting in a few absorbable stitches to give a good cosmetic finish, and finally we close the incision with staples, which are removed about three to five days later.

Surgery takes two hours and patients should feel the benefit immediately. Patients are closely monitored in a high-dependency unit, and will usually have a two-night hospital stay.
The cost of the operation to the NHS is £3,500. Privately, it would cost £5,000.