What it is
One of the most established and reliable operations in spine surgery. The disc is removed through the front of the neck, pressure is taken off the nerve root or spinal cord, a spacer is placed where the disc was, and the two vertebrae are joined so they heal into a single block of bone.
Who it is for
People with arm pain, numbness or weakness from nerve root compression, or with spinal cord compression, where the problem sits in front of the nerves. It is preferred over disc replacement where there is instability, deformity, significant facet arthritis, poor bone quality, or where more levels are involved.
How it works
Through a small transverse incision at the front of the neck, the structures are moved aside without being cut. The disc is removed completely, along with any bone spurs compressing the nerve or cord. A spacer — your own bone, donor bone or a synthetic cage — is placed in the gap, usually held with a small plate and screws. Bone grows across the space over the following months.
Recovery
Many patients go home the same day or the next. Swallowing is often uncomfortable for a week or two and sometimes longer. Desk work typically resumes in one to two weeks, heavier work considerably later. The fusion itself takes three to six months to consolidate and is checked on X-ray along the way.
Risks and alternatives
Bleeding, infection, difficulty swallowing, hoarseness from irritation of the nerve to the voice box — usually temporary — and, uncommonly, injury to the nerves or cord. The fusion may fail to unite, which is more likely in smokers. Alternatives include cervical disc replacement where suitable, a posterior approach, and continued non-operative care.