Symptoms of cervical fusion hardware failure
How familiar are you with cervical spine surgery to treat cervical hernias?
How much do you know about the complications of disc removal surgery and cervical spine fusion therapy?
In the following, we want to talk to you more about the problems caused by hernia correction surgeries or ruptured cervical discs and cervical spine.
Introduction
Discectomy and fusion is a surgery to remove pressure from the root of the spinal nerve that is affected between the cervical vertebrae or pressure in the inflamed spinal cord and causes clinical symptoms in the person (internal cervical dissection and fusion ACDFT) is designed and implemented.
In order to perform this surgery, the surgeon will make a small incision in the front of the neck. And the disc that causes the marks to be removed, and to stabilize the direction of the spine, the fusion is done by filling in the area of the removed disc.
(The connection of the bony parts of the spine is done in the absence and the removed bone)
There are different types of surgical approaches in which surgery and disc resection and then cervical spine fusion are performed. In this article, we want to talk about them as well as the problems that occur after the failure of treatment with these surgeries.
First we need to know a little about the cervical disc and its symptoms.
What is a vertebral disc herniation?
Protruding and ruptured discs are very common causes of pain, tingling and numbness in the neck, shoulder blades and upper back.
What is the anatomy of the spine and what do the discs of the spine do?
One of the most common causes of neck, arm, and shoulder pain is a hernia or rupture of the intervertebral discs. The intervertebral discs are actually the shock-absorbing layers that lie between the vertebrae of our spine. To balance the forces and pressures on the spine, and the spine is a set of bones called the vertebral body, which of course has many bony appendages, the discs allow you to move in the normal range.
As long as the discs and joints in the elderly cervical spine, the head moves normally on the neck and neck movements are allowed in the normal range, allowing the head to be upright.
In fact, discs are like pillows that support the bony vertebrae of the cervical spine. In the center of each vertebra is a hole. The spinal canal is formed by joining and along this hole. The spinal cord and the nerve roots and spinal nerves that are located between the spinal canals that carry messages between the body and the brain.
What are intervertebral disc herniations and ruptures?
In fact, a herniated disc ruptures between the cervical vertebrae when the structure of the disc changes. In young people, the discs are flexible until old age, and the so-called middle nucleus of the disc, called the nucleus, is soft, velvety, and flexible. The disc is surrounded by a very strong fibrous tissue, like a ring, which prevents the transfer of this jelly-like liquid.
How and why does an intervertebral disc herniation occur?
The protrusion of the intervertebral disc is too common due to the pressure on the disc. The nucleus jelly presses against the tight fibrous ring around the disc, and the term hernia occurs, meaning that the disc protrudes out of its natural position. If the input is excessive or the pressure is continuous, the integrity of the turquoise ring around the disc will eventually break and the disc will rupture.
In both cases, the protrusion of the disc herniation and the rupture of the disc, the contents of the disc and the protruding factors that pressure is applied to the spinal roots that protrude from the spinal cord and cause clinical manifestations in the nerve innervation pathway.
What are the symptoms of intervertebral disc herniation and intervertebral disc rupture?
- Headache, especially back pain
- Symptoms of numbness and weakness in the neck and arms of the arms the spread of deadly shooting pain from the neck to the shoulders and sometimes to the fingertips is one of the symptoms that can be mentioned.
Recall that many headaches in a row can be due to hernia and rupture of the cervical disc.
Symptoms and manifestations of cervical disc Problems of the discs between the vertebrae of the cervix can cause sudden and even severe pain. Pain spreads to the arms and hands. Drowsiness Burning and itching can be present along the way. Disc rupture has problems whose manifestations depend on the level of injury.
Symptoms Clinical manifestations of intervertebral disc rupture at different vertebral levels?
The following are the symptoms Clinical manifestations of intervertebral disc rupture at different levels of the vertebrae:
- Rupture of the disc at the level of cervical vertebrae 4 and cervical vertebrae 5
When a rupture of a disc or hernia occurs at this level, the area that will be affected is the area that is innervated by the root of the cervical spinal nerve number five c5. One of its characteristics is a marked weakness of the deltoid muscle, which can cause severe shoulder pain.
The disc problem at this level affects the side of your upper arm and often does not cause sensory disturbances or burning.
- Rupture of the disc at the level of cervical vertebrae No. 5 and vertebrae No. 6
C5-C6
If a disc herniation or rupture occurs in this area, the area of the nerve distribution will be affected by the root of the cervical nerve No.6 c6, and there will be numbness and burning in the side and bottom of the thumb and index finger.
In terms of movement, following a ruptured disc, the muscles of the biceps and the extensor muscle of the wrist are affected at this level.
- Herniated discs and ruptures of the cervical vertebrae at the level of the c6 c7 vertebra and the site where it is supplied by the seven-nerve are affected in this injury.
signs
- Numbness and burning occur along the third and long fingers of the hand, and the triceps muscle behind the arm is also involved.
- Drowsiness and tingling are common in the triceps.
- Disc herniation and rupture of the cervical vertebrae number 7 and thoracic vertebra number one.
This affects the local rupture that is innervated by the first thoracic nerve fiber.
Symptoms include weakness in the ability to squeeze and hold objects with the affected hand. Tingling, numbness, and sometimes arm pain will spread to your little finger.
How is the pain caused by a ruptured disc?
When a ruptured disc occurs at the beginning of this rupture due to compression and stimulation of the nerve root, the person feels very severe pain. During the first six weeks, the ruptured disc begins to contract spontaneously be absorbed.
About 50% of affected cases report improvement in symptoms in the first month and a half.
There is a significant improvement in pain intensity after this 50%, but other symptoms such as tingling, numbness and weakness take longer to resolve.
Diagnosis
When you see a doctor, in addition to taking a history, the doctor diagnoses a disc herniation by examining the symptoms and manifestations along with examinations as well as paraclinical examinations. You will be asked to perform simple movements in the range of motion of the neck joints.
In this way, he can be aware of the ability and strength of the muscle, as well as the range of motion of your joints and the strength of your joints. The nerves that form in this network are responsible for innervating the shoulders, arms, and shoulders, and above the back and elbows to the fingertips.
After evaluation and neurological examination in these areas, it is necessary to check the function of the nerves. From the paraclinical diagnostic methods, we refer to the following:
• Perform simple X-ray imaging
• Spinal myelography
Following spinal myelography, if pressure is applied to the spinal cord or nerve following a ruptured disc, or there is a bone appendage or tumor that has exerted pressure, myelogram images can show this compression factor more clearly.
To see the best bone structures with CT scan, the shape and size of the spinal canal as well as the surrounding structures are determined. MRI imaging is more accurate and sensitive, and the most accurate imaging images of discs or ligaments and spinal cord of nerve roots and tumors are provided by doctors with MRIs.
Emg-ncv muscle nerve tests are a variety of paraclinical diagnostic methods.
treatment
If it is determined that you have a cervical disc herniation or rupture, your doctor will consider treatment options that are appropriate for your condition. As a rule, the most prudent treatment for the symptoms of disc rupture is adopted in the first stage, which is a combination of conservative methods. It is important to note that these methods do not necessarily provide immediate relief, and alleviate the discomfort caused by a ruptured disc, Also, the results of conservative methods such as the ability to maintain and restore flexibility around the damaged disc, which is one of the goals of nonsurgical treatments, take from a few weeks to several months to show themselves. The most important thing is that the patient maintains his cooperation with the treatment team.
Remember that in the course of treatment, you should never perform a new movement arbitrarily or at the suggestion of friends and colleagues, as it can actually cause serious injury.
Leaving aside non-surgical approaches, we move on to surgical approaches that have been developed to treat and alleviate the condition.
Surgical procedures
Spinal surgeries used to relieve and manage cervical disc ruptures are reliable and approved methods. The success rate of these surgeries will be about 95 to 98% only in relieving arm pain.
It is better to know that if the surgeries are performed by an experienced surgeon, the risk of failure is low and the complications of the surgery will be small and transient. The operation can be associated with the least amount of pain after surgery and with the least amount of unpleasant complications and minor side effects. Cervical fusion surgeries have different techniques, which we will mention and explain a bit in the following.
- Anterior cervical discectomy plus fusion of the spine or acdf for short
The most common technique used by spinal surgeons for most people with a herniated disc and rupture of the cervical disc. This procedure begins with a small incision about one inch in front of the neck. From this path, the defective disk is removed and removed. After the disc is removed, a fusion should be made instead. A plate will be added to increase the stability of the spine fusion.
- Posterior cervical discectomy
It is similar to an anterior discectomy, but from the back of the spinal cord may be a good way to treat discs that protrude laterally from the spinal canal. However, technically, the method is more difficult than the anterior technique and requires more experience.
Because there are many important blood vessels in this area, it can cause a lot of bleeding if left untreated, and bleeding from the field of operation reduces the surgeon's vision during surgery.
Posterior surgery will require further manipulation of the spinal cord.
- Replacing the neck disc with a synthetic disc
This procedure is somewhat similar to the technique of anterior cervical discectomy with fusion. In this cervical disc replacement surgery, a defective disc is removed through a small incision made in the front of the neck and an artificial disc is inserted. The fusion is placed in the empty space of an artificial disk in that space.
In fact, the goal is for the disc to artificially mimic the shape and function of a natural disc that has been damaged and removed. Every surgery has side effects. No surgery in the world is 100% safe, but if you leave the surgery to an experienced and skilled spine surgeon you can see the serious side effects below.
What care should be taken after fusion cervical hernia surgery?
This surgery can be performed on an outpatient basis, that means the patient returns home the day of the operation or experiences at least one night of hospitalization. A very positive point is that the arm pain quickly after this surgery and the pressure is removed and goes away, but it may take weeks to months for the numbness to go away.
What are the most common cervical disc surgeries?
Acdf surgery as well as artificial disc replacement surgery are common and reliable surgeries that have good results and will significantly reduce pain in patients.
Note that neck pain can not be abnormal during the recovery period. Most spinal surgeons usually use a special brace that provides more protection after surgery. The type of brace should only be determined by the surgeon.
The type of brace and the time required to use it varies for each person.
In addition, you will be asked to limit your activities after surgery. The amount of restrictions and the duration of the restrictions will vary depending on your condition and will be told by your doctor.
Complications and problems of neck surgeries
Surgical methods are recommended after conservative treatments and non-surgical, that means when a person with conservative points has not seen a result in the clinical response and has severe neck and back pain and sensory-motor symptoms.
Spine and neck surgery is the last treatment option. Neck surgeries have their own complications and it is necessary to pass the necessary advice and knowledge to the patient before the operation.
Complications include bleeding, infection, injuries of the spinal nervous system, leakage of cerebrospinal fluid from the brain, neck pain, stiff neck after surgery, etc.
These complications are related to surgery performed on the front or back of the cervical spine.