FAQ's on Aneurysm Surgery

Q- What is Cervical Discectomy?
Ans- Cervical Discectomy
Neuro-anesthesia specialist and internal medicine consultants will pay visit to you and assess fitness with test including blood tests, X- rays and other radiological tests, Dobutamine stress echocardiogram for cardiac fitness and like. Other specialist may also see you on as and when required basis. Blood grouping and typing will be done so as to be ready for blood transfusion if you so need. Blood will not be routinely required to be reserved for this surgery exception being rare blood groups. Once fit for procedure, a fasting period of 6 hours will be required for anesthesia. Surgery will be done under general anesthesia.
Informed consent will need to be signed so as to permit the surgeon and anesthetist to undertake procedure in good faith. Consent form enumerates the disease process, reasons for undergoing surgery, benefits to expect, risks involved, alternative procedures if any, identifies operating surgeon and needs your informed consent along with a witness signature.
Once in operation theatre, general anesthesia will be introduced by asking you to breath through a mask. Procedure involves a skin crease cut across the side of neck, access to the spine between the carotid artery (artery supplying blood to brain) and the trachea (wind pipe) and the esophagus (food pipe). An X-ray will be taken to confirm the correct level of surgery.
Intervertebral disc will be incised and microscopically removed decompressing the spinal cord and/ or nerve roots. Occasionally an additional incision is made over the anterior aspect of hip to remove small bone piece (7- 8 mm) for use in fusion of adjacent vertebra, alternatively metal case with or without plate is used for fusion. Artificial disc replacement is an alternative to fusion. The wound is closed with or without drainage tube in front of vertebra, which is subsequently removed next morning. Anesthesia will be reversed in operation theatre and you will come out wide awake.
Breathing exercises and anti- embolic stockings help in healthy recovery. Subsequently with a cervical collar and physiotherapist mobilization will be done. After overnight stay under observation in ICU transit to ward will happen. Discharge from hospital will happen by twothree days after surgery. Physiotherapist will assist and teach you maneuvers which are to be continued even after discharge. Stitches may either be self dissolving, subcuticular (buried) or may require to be removed six days after surgery.
Cervical collar needs to be worn for a period of three months, whenever sitting or ambulant. Check X-Rays will be done on follow –up there after to confirm bony healing.
Cervical disc prolapse
Although surgery is relatively safe, it dose carries certain associated risks. The incidence of risks this surgery in our hospital are low and are comparable to any other advanced neurosurgical centre.
Surgical complications include but are not restricted to:
1.1) Injury to larynx (vocal box) and/or nerves to larynx leading to hoarseness of voice which is mostly transient.
1.2) Movement of graft or loosening of instrumentation leading to difficulty in swallowing
1.3) Injury to spinal cord/ nerve root resulting in weakness of arm or legs (< 1%)
1.4) Injury to coverings of spinal cord/ nerves(dura) leading to cerebro- spinal fluid leak predisposing to meningitis and poor wound healing
1.5) Abnormal sensations or numbness in limbs
1.6) Blood clot at operative site leading to breathing difficulties
1.7) Pain in the hip wound (only if graft is taken)
1.8) Infection of wound causing redness and/ or pain with increased incidence in diabetics.
1.9) Injury to the esophagus(food pipe) causing difficulty in swallowing and throat irritation
1.10)Increased risk of chest infection and breathing difficulty especially in obese and smokers.
1.11)Bedridden and those with decreased movements of limbs are at maximum risk of complications.
 After discharge from hospital, for further assistance please contact at following phone numbers: 26825558 / 26925858 or 5801 on ext. no. 2001 and 2012.