Cervical Disc Surgery (Anterior Cervical Microdiscectomy and Fusion)

Transcript translated from Turkish (video audio remains in Turkish)

Hello everyone, I am Dr. Mehmet Levent Deniz, a specialist in brain, nerve and spine surgery. I will now explain the microdiscectomy technique.

Anterior cervical microdiscectomy remains the gold-standard method used worldwide for cervical disc herniations that require surgery. We perform this operation under general anaesthesia. After making a skin incision of approximately 3 centimetres on the front right side of the neck, we move aside the muscles and important blood vessels in this area. We then remove the herniated disc completely and place a material called a cage and a bone graft in the empty disc space.

The operation takes approximately 40 to 60 minutes. The hospital stay is one day.

I wish you all pain-free and happy days. Stay well.

What Is Cervical Disc Surgery?

Cervical disc surgery (anterior cervical microdiscectomy and fusion) removes the herniated disc through an approximately 3 cm incision at the front of the neck and places a cage in the empty disc space.

Who Can Receive Cervical Disc Surgery?

It is used for patients with progressive weakness or persistent symptoms that do not respond to non-surgical treatment. Although in our clinical approach we can help a very large majority of our patients with cervical disc herniation recover without surgery, an operation becomes medically necessary in some situations. The decision is based not solely on a herniation visible on MRI, but on agreement between imaging, symptoms and neurological examination.

• Failure of Conservative and Interventional Methods: Persistent severe arm and neck pain that reduces quality of life and prevents sleep despite non-surgical methods such as medication, physiotherapy and cervical epidural injection.
• Progressive Neurological Loss: Onset of progressive weakness in the arms, hands or fingers (risk of paralysis), weakened reflexes or signs of spinal cord involvement (impaired hand dexterity, unsteady walking) as a result of severe compression of the spinal cord and nerve root by the herniation.

How Is Cervical Disc Surgery Performed?

Under general anaesthesia, the herniated disc is removed under a microscope through an approximately 3 cm incision at the front of the neck, and a cage is placed in the empty space.

Anaesthesia and Entry Point

The operation is performed under general anaesthesia in a fully equipped operating theatre. An approximately 3 cm skin incision is placed within a natural fold at the front-right side of the neck to minimise the cosmetic scar.

Tissue-Preserving Approach

The delicate anterior neck muscles and vital blood vessels and nerves are not cut. Special surgical techniques retract them to the side, providing direct access to the spine.

Microscopic Removal

Under a high-resolution surgical microscope, all herniated disc material compressing the nerve is removed with millimetre precision. This relieves pressure on the nerve root and spinal cord.

Preserving Spinal Stability: What Are a Cage and Fusion?

After the herniated cartilage is removed, special medical materials are placed in the empty disc space to maintain spinal biomechanics and neck alignment:

• Cage: Small cages prevent collapse of the space between the vertebrae and preserve the original cervical height.
• Bone Graft and Fusion: Bone grafts are placed inside the cage to allow the two vertebrae to unite securely (fusion), providing long-term stability at that segment.

How Long Are the Operation and Hospital Stay?

The operation takes an average of 40–60 minutes; patients stay in hospital for one day.

• Operating Time: With the advantages of microsurgical technique, the operation takes an average of 40–60 minutes.
• Hospital Stay: With tissue damage kept to a minimum, our patients can stand and walk a few hours after surgery and are safely discharged after only 1 day.
• Return to Social Life: Thanks to microsurgery, postoperative pain is minimal, and the patient’s return to daily life is much faster than after traditional open surgery.

What Is the Success Rate of Cervical Disc Surgery?

At 5–8 years, 93% of operated patients felt “better” or “much better”, compared with 62% after physiotherapy alone [2]. In appropriately selected patients, surgery provides rapid, lasting relief of arm pain; operated patients recover faster than those receiving physiotherapy alone, particularly in the first year [1]. Benefit is greatest where an actual disc herniation compresses a nerve; the same benefit is not expected for arm pain caused solely by osteoarthritis [3, 4].

What Are the Risks and Side Effects of Cervical Disc Surgery?

Risk is low: the most common problem is temporary swallowing difficulty (5–10%); hoarseness occurs in 1–3% [5, 6]. Both resolve on their own within weeks in most patients, and serious complications are rare [5]. Infection, failure of bone fusion and new nerve injury are uncommon (0.5–2%) [5]. Blood accumulation at the operative site required another intervention in 2.4% of patients; life-threatening risk was one in a thousand [6]. Over time, adjacent-disc degeneration develops in approximately 8% [5]. Older age and multilevel surgery increase these risks [5, 6].

🩺 Physician’s Insight & Clinical Experience

“I fully understand the great anxiety my patients feel when they hear the words cervical disc surgery. With modern microsurgical technology, however, we no longer cut the neck muscles; we simply pass between them. The moment we clear that herniation under the microscope in the operating theatre and free the nerve completely, seeing the patient’s paralysing arm pain disappear entirely while they are still in the recovery room is, as a surgeon, the most satisfying moment of this profession. With a small 3 cm scar and a 1-day stay, we can free our patients from the risk of paralysis and return them to their former health.”

Frequently Asked Questions

What Is Cervical Disc Surgery, and How Is It Performed?

Through an approximately 3 cm incision at the front of the neck, the herniated disc is removed under a microscope and replaced with a cage and bone graft to stabilise the spine. It takes 40–60 minutes.

What Is Its Success Rate?

The great majority of operated patients (93%) feel better after 5–8 years [2]; benefit is greatest where an actual disc herniation compresses a nerve [3, 4].

Does It Have Risks or Side Effects?

Yes, but the risk rate is low: temporary swallowing difficulty and hoarseness are most common and resolve within weeks in most patients [5, 6].

How Long Does Cervical Disc Surgery Take?

It takes an average of 40–60 minutes.

How Long Must I Stay in Hospital After Cervical Disc Surgery?

Patients stay in hospital for approximately one day.

When Can I Return to Work?

Our patients with desk jobs or work without physical loading can return 10–14 days after surgery. Jobs involving strenuous exertion or heavy lifting may require 4–6 weeks.

How Long Should I Wear a Cervical Collar?

Generally 3 weeks. Preserving muscle and bone integrity with microsurgery avoids the need for prolonged immobilisation.

When Can I Get Up?

Our patients can stand and walk under the surgeon’s supervision approximately 4–6 hours after surgery. The next day, they can comfortably climb stairs and walk around the room and are discharged.

When Can I Resume Walking, Sports and Sexual Activity?

Light walking starts the day after surgery; sexual activity resumes after approximately 2 weeks, swimming and light exercise in week 4, and strenuous and contact sports after month 3 with the physician’s approval.

Are Stitches Used, and Will There Be a Scar?

Yes, but cosmetic dissolvable stitches mean no removal is needed. The incision lies within a natural neck crease and is approximately 3 cm long, so it gradually fades to an inconspicuous line.

Is It Normal for Arm Pain to Continue for a While?

Yes, this is an expected recovery phase. A nerve compressed for a long time needs time to recover; aching, numbness or tingling may persist in the first weeks. These symptoms decrease gradually as nerve fibres repair.

Can I Travel by Plane or Bus After Surgery?

Yes, short flights are permitted from the first week after surgery. Bus and car journeys can be made from week 2, taking a break every 2 hours.

Is Cervical Disc Surgery Performed from the Front or Back?

The great majority are performed from the front (anterior approach). Posterior approaches are generally reserved for selected, limited cases where the herniation lies far to the side (foraminal) or multilevel bony canal narrowing is also present.

Does the Cage Stay for Life, and Will It Trigger Security Detectors?

Yes, a titanium or PEEK (special medical polymer) cage is designed to remain in the disc space for life and needs no replacement. Its biocompatible material is not rejected by the body. It generally does not trigger airport or shopping-centre detectors and does not prevent future examinations such as MRI.

Can I Perform Islamic Prayer After Surgery?

Yes. During the first 4–6 weeks, praying seated on a chair is recommended to avoid bending the spine forwards. Normal prayer positions can resume once tissues have healed and neck muscles have strengthened.

Which Specialist Performs Cervical Disc Surgery in Istanbul?

One of the physicians performing cervical disc surgery in Istanbul is M. Levent Deniz, MD, a specialist in neurosurgery.

How Much Does Cervical Disc Surgery Cost?

As treatment costs vary according to the patient and hospital conditions, a definite fee can only be determined after examination and review of imaging.

References

1. Engquist M, Löfgren H, Öberg B, et al. Surgery versus nonsurgical treatment of cervical radiculopathy: a prospective, randomized study comparing surgery plus physiotherapy with physiotherapy alone with a 2-year follow-up. Spine (Phila Pa 1976). 2013;38(20):1715-1722. PMID: 23778373.
2. Engquist M, Löfgren H, Öberg B, et al. A 5- to 8-year randomized study on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone. J Neurosurg Spine. 2017;26(1):19-27. PMID: 27564856.
3. Taso M, Sommernes JH, Sundseth J, et al. Surgical versus Nonsurgical Treatment for Cervical Radiculopathy. NEJM Evid. 2025;4(4):EVIDoa2400404. PMID: 40130970.
4. Dar KH, Alzarooni A, Kaczmarek J, et al. Nonsurgical versus surgical treatment for cervical radiculopathy: a systematic review and meta-analysis of randomized controlled trials. Eur J Orthop Surg Traumatol. 2026;36(1):181. PMID: 42029974.
5. Yee TJ, Swong K, Park P. Complications of anterior cervical spine surgery: a systematic review of the literature. J Spine Surg. 2020;6(1):302-322. PMID: 32309668.
6. Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976). 2007;32(21):2310-2317. PMID: 17906571.

• 👨‍⚕️ Author and medical reviewer of this content: M. Levent Deniz, MD – Neurosurgery Specialist
• ⚠️ Medical Disclaimer: This page is for information only; consult your doctor for diagnosis and treatment.