Surgery for degenerative disc disease in neck

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• Spine Conditions
• Spine Treatments
• Pain Relief
• Staff Spotlight

Degenerative Disc Disease Treatments & Surgery

Have you recently been diagnosed with degenerative disc disease? Has the pain kept you from doing the things you love? If you suffer from neck or lower back pain, then you know how difficult it can be to function normally.

Treatment options are available. In fact, some people achieve relief from degenerative disc disease by using nonsurgical treatments. Others find surgery can ultimately ease their pain and restore function.

Use this guide to understand degenerative disc disease treatments and how surgery can help when other treatment options fail.

What is Degenerative Disc Disease?

To understand degenerative disc disease, let’s first take a look at the spine. As you probably know, the spine plays a major role in protecting your body and supporting its movements. In between each vertebra of your spine lies an intervertebral disc. These discs allow the spine to generate movement and have flexibility. In addition, these discs serve as shock absorbers, protecting your vertebrae during everyday activities.

Spinal discs consist of a strong fibrous cartilage (the annulus fibrosus) which encloses a gel-like inner layer (the nucleus pulposus). As we age, these discs can weaken and become injured because of our personal habits, activities, diseases, and genetics. Degenerative disc disease is an umbrella term for neck and back pain associated with disc damage.

There are two common injuries associated with degenerative disc disease. A bulging disc occurs when an intervertebral disc loses its shape and “bulges” outside its normal perimeter in the spine. A slipped disc, on the other hand, occurs when a crack in the outer layer causes the inner layer to rupture outside of the disc. While both conditions can cause symptoms, a slipped disc tends to be more painful. The most common symptom of degenerative disc disease is continuous pain in the affected area. In addition, nearby muscles can become stiff, weak, or even spasm. Some patients even experience radicular pain–pain that starts at one area and shoots to other areas of the body such as the arms and legs.

Since certain parts of the spine are more mobile than others, degenerative disc disease usually affects two main areas of the spine. Common types of this disorder include:

• Cervical Degenerative Disc Disease: When degenerative disc disease affects the neck; often leads to stiffness, decreased range of motion, and numbness.
• Lumbar Degenerative Disc Disease: When the lower back is affected; often causes pain in the lower body and discomfort when bending, lifting, or performing other lower limb movements.

Treatments for Degenerative Disc Disease

As mentioned earlier, some cases of degenerative disc disease respond well to nonsurgical treatments. Consulting with a doctor or orthopedic surgeon can give you valuable insights into the best way to treat your pain. The main goals of treatment involve reducing pain and preventing any painful flare-ups due to inflammation or added injury.

Your first line of defense for a degenerated disc is often modifying activities, making lifestyle changes, and resting the affected area. In addition, medications can relieve pain and lessen inflammation. Your doctor may also recommend using heat or ice treatments to relax the affected muscles and prevent more inflammation.

Other holistic disciplines can also help to ease your symptoms. A physical therapist can suggest stretches and exercises to keep the target area strong and flexible. And, chiropractors can adjust the spinal structures to relieve pressure and tension on the joints. Some people also find relief in the manual manipulations performed by a massage therapist.

When to Consider Surgery

While the thought of spine surgery may seem a little overwhelming, it can allow you to finally get your life back from chronic pain. Surgery is rarely suggested unless other treatment options aren’t helping. You may want to consider surgical treatment if:

• Other treatments have failed. If you’ve tried nonsurgical treatments for up to six months without success, then surgery may be an option.
• Only one or two discs are damaged. Surgery on a single disc (or two) still gives your spine the mobility it needs to function properly.
• Your body has the ability to recover. Younger people tend to respond to surgery better because their bodies recover faster with less dangerous complications.
• You develop cauda equina syndrome. This rare, but serious, condition develops when a bundle of nerve roots in the lower spine becomes compressed. It can result in paralysis, loss of bladder or bowel control, and other major complications.

Surgical Treatment Options

If you feel surgery is the best option for your degenerative disc disease, then your doctor or orthopedic surgeon will conduct a thorough examination and order diagnostic tests. After reviewing the results, you and your doctor will discuss the best surgical treatments for you.

Sometimes, an orthopedist can repair discs with surgery. Other times, they are removed and replaced with pieces of bone and/or other hardware. Here are some common surgical treatment options for disc degeneration:

Spinal Decompression

When a disc suffers damage, it loses its shape and can press on the spinal cord or other nerve roots. In addition, it may create structural changes in the spinal column resulting in nerve pressure. A surgeon can remove tissue or pieces of bone that press on the nerves to relieve pain and free up space for these structures. These procedures referred to as spinal decompression.

Common types of decompression surgeries include:

• Laminectomy: The lamina is a bony plate on the back side of a vertebra. It is part of the spinal ring that protects the spinal cord and canal. Changes in structure may cause it to press on the spinal cord. This procedure removes some or all of the lamina.
• Foraminotomy: Spinal nerves branch out to the rest of the body through a bony hollow known as the foramen. Sometimes part of an injured disc or a small overgrowth of the vertebrae presses on the nerves as they leave the foramen. A foraminotomy involves making the opening of the foramen larger to eliminate nerve compression.
• Facetectomy: Facet joints at the back of the spine allow movement and provide stability. Healthy facet joints have cartilage to facilitate our movements. If your spine structure has changed, however, these joints may put pressure on nearby nerves. During this procedure, your surgeon will remove the facet joints to relieve compression on the nerves.

Discectomies

Sometimes a disc is so damaged due to disease or injury that it needs to be removed. Discectomies are usually minimally invasive surgical procedures that remove the entire disc or a damaged portion. Common discectomies include:

• Microdiscectomy: Using minimally invasive techniques, the surgeon removes the herniated portion of a disc that presses on a nerve. Since your doctor only removes a small portion of the disc, the rest of the disc remains intact.
• Artificial Disc Replacement: When some or all of a disc needs to be removed, the surgeon may elect to replace it with a disc prosthesis that functions like a normal disc. This can include a total disc replacement or an implant in the center of the disc.

Spinal Fusion Surgery

When the disc or other structures are removed, sometimes a surgeon needs to graft two vertebrae together to keep the spine stable. Over time, these grafts allow two vertebrae to grow together as one (fusion).

Common spinal fusion surgeries include:

• Anterior cervical discectomy and fusion (ACDF): This is a common treatment option for those with neck pain due to degenerative disc disease. The surgeon makes a small incision in the throat to remove a damaged disc. Then, your doctor will insert a graft to allow the bones to fuse together.
• Anterior lumbar interbody fusion surgery (ALIF): Similar to an ACDF, an ALIF surgery provides relief for those with degenerative disc disease in the lower back. Usually, the surgeon makes the incision on the left side of the stomach area. Then the damaged disc is removed and a bone graft and other hardware are inserted to stabilize the area and facilitate spinal fusion.
• Posterior lumbar interbody fusion (PLIF): Depending on your condition, the surgeon may elect to make an incision in the back to remove a disc and insert grafts.

Deciding Which Surgical Treatments are Right for You…

If degenerative disc disease is limiting your quality of life, then you probably have many questions about which surgical treatments are best for you. Deciding to undergo surgery on the spine is not an easy decision. Our back pain specialists at the Advanced Spine Center are ready to help you.

By getting to know you, your condition, and goals for treatments, our experts at the Advanced Spine Center can help you make informed decisions about your recovery options. Our orthopedic doctors take the time to explain the different procedures, risks, and recovery times, empowering you to make the best choice between treatments.

If you need surgery, our specialists use the latest technology to help you achieve relief faster. Minimally invasive techniques exact less damage to the body and leave smaller scars. Schedule a consultation today to find out how the Advanced Spine Center can help you return to life–pain-free!

Dr. Charles A. Gatto, M.D.

Dr. Charles A. Gatto, M.D.

Dr. Gatto is board certified by the American Board of Orthopaedic Surgery and has extensive training in all aspects of spine surgery, with a particular interest in spine trauma, degenerative spinal disorders, work-related spinal conditions, and the advancement of minimally invasive techniques. Dr. Gatto’s approach to treatment is very conservative, fully utilizing all diagnostic options and preferring to exhaust all non-operative avenues before considering surgery.

Dr. Jason E. Lowenstein, M.D.

Dr. Jason E. Lowenstein, M.D.

Dr. Lowenstein specializes in the treatment of spinal deformities, including scoliosis, kyphosis, and spondylolisthesis. He has extensive experience in treating disc herniations and stenosis of the cervical, thoracic, and lumbar spine, and utilizes endoscopic techniques as well as artificial disc replacement for treatment of these disorders. He has a particular interest in complex revision surgery for patients who have had previous spine surgery and have associated failed back syndrome, and is also skilled in minimally invasive spine surgery.

Dr. George S. Naseef, M.D.

Dr. George S. Naseef, M.D.

Dr. George S. Naseef is a partner at the Advanced Spine Center and is a board certified, fellowship-trained spine surgeon. He is active member of the medical staff at Morristown Medical Center, and currently is the Vice-Chairman of the Department of Orthopaedic Surgery.

Tanya Lugo, PA-C

Tanya Lugo, PA-C

Education: Long Island University, Health Science - Specializing in chronic pain and spine health

Sarah Ries, PA-C

Sarah Ries, PA-C

Education: Masters of Science - Physician Assistant Studies at Seton Hall University; Bachelor of Science - Rehabilitation Science University of Pittsburgh

Matthew Hirschhorn, PA-C

Matthew Hirschhorn, PA-C

Education: Pennsylvania State University

Michele Lohman, PA-C

Michele Lohman, PA-C

Education: Masters of Science - Physician Assistant Studies at Seton Hall University; Bachelor of Science - Biology at Seton Hall University

Real Testimonials

Dr. Jason Lowenstein in a expert in his field and a caring doctor. He totally straightened me from having scoliosis and I am able to walk without pain. I had to go through a few surgeries but well worth it, as I am recovering very well! I have already recommended him to a friend and will continue to do so. He is the best in what he does.

Dr. Gatto is simply the best. He performed a discectomy to fix a bad herniated disc that caused 12 months of constant pain and discomfort. I felt relief immediately after the surgery and now, 4 months after the surgery, it's as if I never had the problem to begin with. He always made me feel comfortable and completely at ease about the procedure.

Dr. Naseef is an excellent surgeon who resolved my back issues. I suffered from December to April with chronic back pain, enduring injections, physical therapy, and bed rest. In April, the good Doctor operated on my back. I went into surgery in pain, and awoke several hours later pain-free. It has been over a year and I completely pain free.

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