This operation is most commonly performed to relieve compression of the spinal cord as well as the nerves of the cervical spine (myeloradiculopathy). This compression may manifest in balance difficulties, a lack of coordination, impaired dexterity, fatigue , pain and heaviness in the upper limb amongst other symptoms.


The condition is diagnosed with a history an physical examination and corroborated with medicalimaging of the cervical spine including an MRI scan.


Non operative treatment includes , pain-killers, physical therapy and local anaesthetic and corticosteroid injections.

The natural history of cervical myelopathy is for patients to suffer from a steady deterioration in function, thus operative therapy is usually recommended. Preoperative patients are seen by physicians as well as anaesthesist so as to mitigate the surgical risks.


This involves a small incision, typically one and a half inches, in the front of the neck. There is a dissection between muscle and tissue planes to approach the cervical spine. The diseased disc segment is excised under microscopic guidance and replaced with an inert implant to facilitate fusion of the diseased segment. The spinal cord and nerves are monitored with electrophysiological monitoring to minimise risk.


After surgery patients may experience pain in the region of the incision. Some neck and arm pain as well as tingling or numbness may also be present. Initially it may be of greater intensity than pre-operatively, but will subside over time as the healing process occurs. This discomfort is caused from surgical retraction of tissue as well as inflammation and swelling of the previously compressed nerves.

Some patients experience a sore throat and swallowing difficulty after general anesthesia and surgery. This is from manipulation of tissue and the presence of the breathing tube for anesthesia. The sore throat usually will subside within a week. The swallowing difficulty may take longer. Using throat lozenges or lemon drops, sipping cool liquids, or sucking ice chips may soothe this pain.

Use of Pain Medication

Narcotic pain medication will be available for pain relief after surgery. Narcotics are very effective for pain relief but may cause other side effects. The possible effects vary among patients and may include: sleepiness, nausea, constipation, flushing, sweating, and occasionally euphoria or confused feelings. If these occur notify your nurse. For your protection, you will receive narcotic medication only when you request it and if deemed medically appropriate by your physician.


Patients are encouraged to mobilise with the assistance of a nurse or physical therapist as early as 4 hours after surgery. Early activity after surgery is extremely important to help prevent the complications of prolonged bed rest such as pneumonia and blood clots. It also promotes recovery, relieves muscle stiffness, allows for development of a well-organized scar, and improves your outlook.

Elastic stockings (TED hose) were given to you immediately after surgery to prevent phlebitis (inflammation in your veins) in your legs. You may remove them after being discharged from the hospital. Do not start any programs of exercise or physical therapy unless discussed with your physician or Dr Nair


Your diet will begin with clear liquids, and be advanced to your normal daily diet as soon as your condition permits. Your IV will be removed as soon as we are reasonably certain it will no longer be required for medications and hydration.

Bowel and Bladder Function

During surgery patients willl have a catheter (tube) in the bladder to monitor your urine output. Upon its removal you may feel a stinging sensation for 2 to 3 days, which is normal. Some patients may have difficulty urinating after surgery. If this occurs, notify your nurse who may assist you in voiding techniques. This may require placing a catheter in your bladder. After surgery, constipation frequently occurs from inactivity and the side effects of pain medication. Stool softeners and laxatives will be available.

Respiratory Hygiene

Deep breathing is very important after surgery to maintain lung expansion and reduce the risk of pneumonia. Patients will be provided with an incentive spirometer and instructed about its use. This device should be used every 15 to 30 minutes during your wakeful hours initially, then every 1 to 2 hours as your

Activity returns to normal. This device is yours to take home. Continue to use it at home for at least 1 week after your discharge.

Smoking is strongly discouraged. There is clear evidence that smoking dramatically increases your risk of post-operative complications. There is also evidence that smoking adversely effects bone healing and nerve recovery. Second hand smoke also applies, so family members and friends should avoid smoking while around you.

Use of Your Neck Collar

Patients may be prescribed a neck collar based on various technical considerations. Typically this is a soft collar to be used when driving or in the community

Follow-Up Appointment

Patients are generally discharged from the hospital 3-4 days after surgery. A follow-up appointment should be made for Dr Nair’s office 2 weeks from the date of surgery. At your 8 week follow-up visits, you will receive an x-ray of your neck the morning of your appointment.

Incision Care

After the 5th post-operative day, patients are encouraged to shower daily. You are advised to leave the impearable dressing on for a total of 2 weeks. A supply will be provided upon discharge. Do not soak your incision. Pat the incision dry. Do not apply any ointments or creams. A supply will be provided upon discharge. Surgical tapes or Steri-strips may be present to aid in holding the skin edges together. Allow these to fall off on their own.. NO BATHS, HOT TUBS, OR POOLS FOR 6 WEEKS AFTER SURGERY, it will increase your risk of infection.


Please take your temperature every afternoon for the first week after you are discharged from the hospital. Call Dr Nair’s office if :

  • Your temperature taken by thermometer, is more than 101.5 degrees,
  • Your incision becomes reddened, swollen or any drainage occurs, or
  • Your pain increases out of anticipated parameters.


A well-balanced diet is necessary for good healing and recovery. This includes food from the four basic food groups: dairy products, meat, vegetables and fruit. Use of narcotic pain medication and prolonged rest may cause constipation. Drinking plenty of fluids and eating high fiber foods (whole grains, raw fruits and vegetables) will help regain normal bowel function.

Home Pain and Medication

When we surgically relieve pressure from an inflamed, damaged nerve it does not recover instantaneously. The surgical procedure does not heal the nerve, only the body is capable of that. The goal of surgery is to create the best possible environment for the body to heal itself and to prevent further damage. This will take a variable length of time depending on the duration and degree of nerve damage and the body’s own healing abilities. Most of the healing occurs in the first few months. Pain, weakness, or numbness lasting more than six months will likely be permanent.

Everyone has a different pain tolerance that will dictate the amount of pain medication required. A decreased dose and less frequent use of pain medication will occur during your recovery period. A gradual weaning of medications should begin as soon as possible, generally within 2 to 4 weeks. Conservative use of narcotic pain medication is advised. One should try non-narcotic medication, such as Panadol and reserve narcotics for more severe pain. While using narcotic pain medication you SHOULD NOT drive. One should try non-narcotic medication, such as Panadol and reserve narcotics for only the difficult times. Do not take anti-inflammatory medicines such as Celebrex, Voltaren, Mobic, or Diclofenac, as these may affect your bone healing for 12 weeks following your surgery.

Home Activity

Your recovery is an essential part of your surgical process. Following these guidelines and the instructions given to you by your physician and nurse will provide you with the best opportunity to return to your desired activities as completely as possible.

The First Week

  • Early to bed, late to rise and frequent rest periods throughout the day. Get at least 8 hours of sleep each night. A disrupted sleep pattern is common after discharge from the hospital and will return to normal over time.
  • You may not drive, but you may be driven, for short distances, using proper restraints such as shoulder and lap belts for 2-4 WEEKS.
  • No lifting of more than 4 pounds
  • May climb stairs with hand rail
  • Begin a daily walking program with 1 to 2 blocks initially; schedule a daily time and increase distance daily.
  • Eat a regular, balanced diet.
  • Take medications as prescribed, using narcotics as needed.

The Second Week

  • Resume normal rising and retiring schedule, but continue to rest throughout the day.
  • You may not drive.
  • No lifting of anything weighing more than 4 pounds.
  • May climb stairs with hand rail
  • Continue scheduled walking, increasing distance and frequency as able.
  • May resume sexual relations when comfortable.
  • Begin narcotic weaning as pain diminishes, relying mainly on non-narcotic medications
  • Follow-up for review of perioperative status, as scheduled, for further instructions.

The Third Week

  • Resume normal rising and retiring schedule, resting as needed.
  • May resume light work around the home; lifting not to exceed 10 pounds.
  • Continue scheduled walking.

The Fourth Week

  • Resume normal rising and retiring schedule, resting as needed.
  • May resume light work around the home; lifting not to exceed 10 pounds.
  • Continue scheduled walking.

The Sixth to Eight Week

  • You will be followed up in Dr Nair’s rooms for clinical and radiological assessment.


The usual period of recovery for cervical disc surgery is 8 to 12 weeks and complete healing may take from 3 to 6 months. Some patients may return to work sooner than others depending on their job, response to surgery, and ability to perform other lighter tasks in the work place. Physician approval is required prior to returning to work