Dr Adriaan Liebenberg My Spine Cervical | Page 101

My Spine - Cervical
The length of the incision depends on various factors such as patient size,
number of spinal levels involved and your specialist's preference. The length
of the incision is actually of little consequence with regards to the success of
the operation. The amount of soft tissue dissection does, however, dictate the
amount of post operative pain.
The specialist can follow a midline approach, which actually means that no
muscles have to be cut into. This would require a large cut to expose the side
of the neck where the decompression has to be performed and is used when
multiple spinal levels have to be decompressed. Another approach is to make
a small incision directly over the point where the decompression has to be
done (see Figure 15.1), and this approach is preferred if there is only one or
two nerves that are being compressed.
The muscles are displaced to the sides and the lamina of the vertebra exposed
– this is the flattened part of the back of the vertebra (see the chapter Anatomy
of the Spine). An X-ray is taken to confirm the correct level and the decom-
pression of the nerve is started. This is normally done by using a fine drill to
make a keyhole shaped opening in the bone overlying the nerve.
If there is any disc material compressing the nerve, this may now be removed.
Afterwards the wound is closed in layers using sutures and covered with a
dressing.
Ward care
You may get out of bed soon after this operation, usually on the first day. You
may move around freely, because the spine is not destabilised by this opera-
tion. Some specialists may prescribe a soft collar for comfort. Analgesics are
normally prescribed for post-operative pain.
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