Patient information
Information for Patients Undergoing Cervical
Discectomy
Trauma and Orthopaedic Directorate
PIF 1358/V2
The surgical procedure that you are to be admitted for is called a cervical discectomy. This is
performed for someone who has a prolapsed (slipped) disc in the neck area.
Your spine is made up of small bones called vertebrae which all sit on top of each other to form
your spinal column. To stop these bones from rubbing on each other you have intervertebral
discs. These are soft cushions of tissue which sit in between each of the bones in your spinal
column and act as shock absorbers.
The spinal cord and nerves run through your spinal column. This acts as a telephone exchange
passing information from your brain to your body and back again. At the level of each bone
(vertebra) it sends out some nerves to transmit these messages to and from your body. A
prolapsed disc occurs when one of these cushions (discs) slips out slightly and puts pressure on
one of your nerves, or your spinal cord itself, causing your symptoms.
Your Consultant / Doctor has advised you to have a Cervical Discectomy.
What is a Cervical Discectomy?
Discectomy involves having a small cut at the front of your neck just below the collar line while
you are asleep under general anaesthetic. A microscope is used during your operation, so the
surgeon has a better view of your tissues and to reduce the disturbance to the surrounding
structures, improving the accuracy. The front of your spine is exposed, the disc is approached
from the side and the bit that is pressing on your nerve is removed. Although a large part of your
disc is removed, the complete disc is not taken out.
Some patients require a graft or a cage in addition to their discectomy. If this is to be part of
your surgery then your doctor will have already discussed this with you.
A graft is addition of either your own bone or donor bone (bone from someone else), into your
operation site to stabilise the bones of your spine. When bone is removed during surgery to
allow access to the disc space or if your bones normally have too much movement in them, they
can become unstable. They then sometimes need to be packed in order to keep the structure
stable and allow fusion of the spinal bones (the spine to become solid and stable) following
surgery. The bone used to pack the space is either your own taken from the front part of your
pelvis just behind your hip (during the operation), or donor bone that is accessed from a source
that has undergone all the rigorous testing required.
A cage is made of metal coated with carbon fibre and is used as an aid to stabilising the
structure.
If you have any concerns about this please discuss it with the medical staff or contact the Spinal
Nurse Specialist for advice. (The Spinal Nurse Specialist’s number is at the back of this
information leaflet).
What are the benefits of having Cervical Discectomy?
The aim of surgery is that it gives a chance of relief from arm pain only and not neck pain.
However there is no guarantee that there will be any improvement in any weakness or
numbness that you may have had prior to surgery.
What are the risks of having Cervical Discectomy?
All the risks will be discussed with you prior to your surgery and although they are not common
you should be aware that there is the potential for them to occur.

Risk from anaesthesia.

Small risk of persistent or increased pain.

Risk of injury to your nerves or spinal cord causing weakness or numbness. In the
extreme this can result in total paralysis (unable to move from the neck down) but this is
an exceptionally rare complication.

Sore throat/ swallowing problems, due to manipulation of your throat structures during
surgery, to allow access to the front of your spine (this should settle down in a few days).

Vocal cord problems, hoarse voice (although this should settle down within a few days).

In theory there could be injury to the nerve for sweating, eye lid and the pupil (Horner’s
syndrome) although this is also exceptionally rare.

Leak of spinal fluid.

Infection, which includes infection from the MRSA bacteria (infection with MRSA is very
rare).

Bleeding or Haematoma (collection of blood).

In patients having a graft or cage there is potential for the graft or cage to slip forward
and move out of the correct position.
It is possible for another piece of disc to move out and cause pressure or a prolapsed (slipped)
disc can occur at another level in your spinal column at some time in the future.
As already mentioned complications are rare, if you are worried about any of the aspects of
surgery you will have the opportunity to discuss any concerns prior to surgery, following your
hospital admission.
Are there any alternative treatments available?

Allow your body to heal naturally and the symptoms will resolve as the slipped part of
disc reduces itself, and the pressure on the nerves is relieved.

Physiotherapy treatment, Pilates, Tai Chi and Yoga all of which will help with posture and
muscle tone.

Managing the pain with medication. In some cases Osteopathic treatment or injection
therapies may help.
What will happen if I decide not to have treatment?
If the pain does not settle spontaneously and persists with a degree of severity then surgery can
be considered. Surgery allows relief of pain in most cases. It has less effect on any sensory
changes you may have, such as pins and needles and numbness. If there is some muscle
wasting (loss of muscle bulk), then this is usually irreversible but this may be improved by a little
focused exercise after successful surgery. Surgery may allow the relief of symptoms earlier than
if you wait for the natural healing process to complete.
If you are worried about any of these risks, please speak to your Consultant or a member
of their team.
Getting ready for your Cervical Discectomy
Pre-operative assessment
You will be brought into the hospital to Spinal clinic for your pre-operative assessment. Preoperative assessment is important for us to make sure that you are safe to have your operation
and that we have everything in place for your needs.
This assessment includes:

A member of the spinal team will discuss your medical history with you and you will be
examined in pre operative clinic

You may be reviewed by an anaesthetist; he/she will have a chat with you, discuss any
relevant medical history and explain what having an anaesthetic will involve.

You may have some blood tests performed.

If any X-rays or a heart trace (ECG) are required these will also be done.

Your drugs may be prescribed so it would be helpful if you bring with you any medication
that you are taking or a list of your medication and doses.

If you are on medication that thins the blood you will be asked to omit this medication as
follows prior to your surgery:
o
o
o
o
Aspirin- seven to ten days
Clopidrogrel -seven to ten days
HRT- one Month
Warfarin- four days.
Please leave all cash and valuables at home. If you need to bring valuables into hospital, these
can be sent to General Office for safekeeping. General Office is open between 08.30am and
04.30pm Monday to Friday. Therefore, if you are discharged outside these times we will not be
able to return your property until General Office is open. The Trust does not accept
responsibility for items not handed in for safekeeping.
Admission to hospital
In most cases you will be admitted the morning of your surgery to 11Z fasting, but in some
cases you will be admitted the day before your surgery. If this is going to happen it will be
discussed with you and any instructions given to you in advance.
Operations may be delayed, postponed or cancelled depending on your suitability of
anaesthetic or availability of high dependency beds if there are indications you require one for
this operation.
The day of your Cervical Discectomy
You will be kept fasted (nothing to eat or drink) and need to wear a theatre gown following your
morning bath or shower at home.

Your details will be checked with you on the ward, before you go to theatre. You will be
wearing a wrist band and have to answer a list of questions, for example, your name, date of
birth.

You will be collected for theatre and taken to the theatre reception area where the nurse will
check your details again; While this can appear repetitive it is all done to ensure your safety.
You will be taken to the anaesthetic room where the anaesthetist will give you your
anaesthetic medication, and once you are asleep you will be taken into theatre and surgery
performed. It is common for X-rays to be used in theatre to assist the surgeon with checking
the correct position of your neck bones.

After surgery you will be taken into the recovery room where you will be monitored as you
wake up from your anaesthetic, and you will be made comfortable for your transfer back to
the ward. You will be transferred back to the ward after spending time in Recovery. On
return to the ward your observations, for example Blood Pressure and Pulse will be
monitored regularly, as will your wound and your limb power and movement.

It is common to have a small drain in place within the surgical wound to remove any excess
fluid. This usually remains in place overnight.

An intravenous infusion (drip) will be attached until you are awake enough to eat and drink
again.

You will have an oxygen mask over your nose and mouth until you are fully awake. This is
usually removed following time on the ward.

Your pain will be controlled with injections initially and then the following day you will be able
to have tablets. You will be encouraged to move around the bed as much as possible and if
you feel well enough you will be able to get out of bed to pass urine.
The day after surgery
The day following surgery your wound will be checked and the drain will usually be removed.
You will be encouraged to get out of bed and move around, the physiotherapist will see you to
explain correct posture and the exercises that you will need to do.
It will be explained to you if you have had a cage or graft inserted and If you have had a cage or
graft inserted you should be careful not to do excessive movements of your neck for the first
week, in order to protect the position of the cage/graft until it settles into place. Some patients
may require an X-ray of their neck the day after surgery, and/or may need to wear a neck collar,
this depends on the type of surgery performed, the medical staff will make this decision for each
individual patient and you will be informed of this.
One of the spinal team will check how you are managing. Following this you will normally be
able to go home in the afternoon; it is quite normal practice to go home the day after your
operation.
Going home
It would be better if you can arrange to have some pain killers at home for when you are
discharged as it can mean you have to wait until late on your discharge day for any we arrange
to arrive. Medication can be organised for you to take home if this is not possible.
Your sutures (stitches)/clips will be due to be removed or trimmed approximately seven to ten
days after your surgery. Most patients make an appointment to get this done by their GP
practice nurse or walk in centre.
You will have waterproof dressings which are not to be removed for the first seven days and if
there are any problems regarding this please contact one of the staff on the ward.
It is advisable for you to arrange your own transport home prior to admission. If you are
travelling home by car sit in the front passenger seat and recline the seat back to make you
more comfortable whilst travelling.
It is not unusual for you to get increased pain or altered sensation for a few days to a few weeks
after surgery.
Research has shown that patients who return to a normal routine as quickly as possible make
the best recovery. You should progressively return to your normal daily routine as you continue
to recover. You can return to work as soon as you feel you can cope even if you feel
uncomfortable. You shouldn’t lift heavy object for three months. You will be sent an outpatient
appointment for approximately three months by post to come and see the spinal team so we
can check you are recovering well.
Discharge information
Pain relief and medication
The nursing staff will advise you about painkillers before you leave the hospital. Please tell the
nurses what painkilling tablets you have at home.
Getting back to normal
Remember that you have just had an operation. It is normal to feel more tired than usual for a
few days afterwards.
The physiotherapist will visit you during the day after your operation. The movement and
strength of your limbs will be assessed so that an exercise programme can be made for you.
You will be expected on your first day post-op to be walking around.
Good posture is important as it gives minimum strain on your joints and ligaments in the spine
and therefore will reduce the recurrence of neck and back pain. When you have poor posture,
the body’s proper vertical position is out of alignment and the back’s natural curves become
distorted.
Try to avoid:

Head forward or slouched posture.
 Slumped sitting posture
Further Information
The Spinal Team are:
Mr M De Matas Consultant
Mr S Thambiraj
Secretary
Tel: 0151 706 3651
Textphone Number: 18001 0151 706 3651
Spinal Nurse Specialist
Tel: 0151 706 2000 - Bleep 4099
Textphone Number: 18001 0151 706 2000 Bleep 4099
Author: Trauma and Orthopaedic Directorate
Review Date: February 2017
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