Cervical-brachial Pain (cervicobrachialgia)

 

Article written by : Dr. Luciano Mastronardi

If the treatment of cervical-brachial pain with immobilization (collar) for at least 40 days and the subsequent physiotherapy or swimming on the back does not relieve the pain or even appears a motor deficit, surgical intervention is indicated. The goal of surgery is to remove the herniated disc and possible osteophytic formations in order to decompress the neural structures and ensure the stability of the cervical spine by application cages in place of the removed disc.
In detail, access to the cervical spine occurs with an anterior approach to the neck. The intervertebral disc is then removed with use of microsurgical technique and a “cage” is positioned in the disc space (PEEK cage, tantalum, carbon fiber or other inert material containing osteoinductive material) or a mobile disc prosthesis (total disc replacement), in relation to the age of the patient and other aspects.
In other words, the degenerated disc is replaced and is induced the fusion of the vertebral bodies adjacent to the herniated disc or, when indicated, restored the movement through a disc prosthesis. After surgery, the patient can be mobilized immediately and discharged on the second day. An X-ray examination of the neck will confirm the success of the intervention and the patient should wear for about 20 days a Schanz collar (not necessary in case of mobile prosthesis).
The success rate for this type of intervention is very high, since an non-traumatic access allows an optimal decompression of the neural structures, solving the cervicobrachialgia and any neurological deficits. The results are less successful for the treatment of myelopathy, very related to preoperative conditions of the patients.
In other words, the degenerated disc is replaced and is induced the fusion of the vertebral bodies adjacent to the herniated disc or, when indicated, restored the movement through a disc prosthesis. After surgery, the patient can be mobilized immediately and discharged on the second day. An X-ray examination of the neck will confirm the success of the intervention and the patient should wear for about 20 days a Schanz collar (not necessary in case of mobile prosthesis).
The success rate for this type of intervention is very high, since an atraumatic access allows an optimal decompression of the neural structures, solving the cervicobrachialgia and any neurological deficits. The results are less successful for the treatment of myelopathy, very related to preoperative conditions of the patients.

 

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