Condition
Cervical Radiculopathy
Treatments
Anterior Cervical Discectomy and Fusion (ACDF)
If a herniated disc is compressing the nerve, the disc may need to be removed. Once this is removed, a graft must be placed where the disc used to be. Sometimes it is beneficial to fuse the vertebra together, a procedure known as an anterior cervical discectomy and fusion (ACDF).
In this procedure, a graft is placed, which enables the two vertebrae to become one as they heal. This is usually performed if there are advanced degenerative changes.
Cervical Disc Replacement
Other times, once the disc is removed, a disc replacement can be placed. This device preserves motion at the level of the removed disc and eliminates the need to fuse two bones together.
Doing so preserves the natural biomechanics of the spine and when compared to fusion can reduce the rate of further degeneration as well as the risk of future surgery. This procedure can usually be performed if the degenerative changes are mild.
Case Study - 77 year old
A 77-year-old woman first noticed shooting pain down her right arm after playing a round of golf. This pain persisted for weeks and an MRI was done which demonstrated severe narrowing between the fourth, fifth, and sixth vertebrae in her neck, resulting in severe nerve compression.
She initially underwent non-surgical treatments, including physical therapy, oral pain medications, and injections. Her symptoms persisted despite these treatments, therefore surgery was performed.
We performed a two level anterior cervical fusion, where the C4-5 and C5-6 discs were removed and grafts were placed that would restore the loss of height at these levels. She had complete resolution of her pain immediately after surgery, and has been pain free since.


Case Study - 41 year old
A 41 year old woman developed increasing weakness in both of her hands over the course of 10 years. In addition, she was experiencing shooting pain down both of her hands and into her thumb and index finger on both sides. These symptoms worsened over time despite non-surgical treatment.
An MRI demonstrated a C5-6 herniated disc. Given that there were few other degenerative changes, a disc replacement was performed. After surgery, her pain completely resolved, and she returned to having full strength in both of her hands. On her imaging, you can see preserved range of motion in the neck after disc replacement.


