Cervical Disc Surgery (Anterior Cervical Microdiscectomy and Fusion)

Many patients with cervical disc herniation improve without surgery. Surgery becomes necessary for progressive weakness or resistant cases that do not respond to non-surgical treatment. The standard method is anterior cervical microdiscectomy and fusion. It is performed through a small incision of approximately 3 cm at the front of the neck, takes an average of 40–60 minutes and requires a 1-day hospital stay.

When Is Cervical Disc Surgery (Microsurgery) Necessary?

Although our clinical approach helps a very large proportion of patients with cervical disc herniation recover non-surgically, an operation is medically necessary in some situations. The decision is not based solely on a herniation visible on MRI, but on agreement between imaging, symptoms and neurological examination. In our clinic, it is considered in two clinical situations:

• Failure of Conservative and Interventional Methods: Persistent severe arm and neck pain that reduces quality of life and prevents sleep despite medication, physiotherapy and cervical epidural injections.
• Progressive Neurological Loss: Severe compression of the spinal cord and nerve roots causes progressive weakness in the arms, hands or fingers (risk of paralysis), weakened reflexes or signs of cord involvement, such as impaired hand dexterity and unsteady walking.

How Is Anterior Cervical Microdiscectomy Performed?

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 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?

• Operating Time: With the advantages of microsurgical technique, the operation takes an average of 40–60 minutes.
• Hospital Stay: Minimal tissue damage allows our patients to stand and walk a few hours after surgery and be safely discharged after only 1 day.
• Return to Social Life: Postoperative pain is limited, and return to daily life is much faster than after traditional open surgery.

What Is the Success Rate?

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

What Are the Risks?

Serious complications are rare [5]. The most common problem is temporary swallowing difficulty (5–10%); hoarseness occurs in 1–3%. Both resolve spontaneously within weeks in most patients [5, 6]. Infection, failure of bone fusion and new nerve injury are uncommon (0.5–2%) [5]. Blood accumulation at the operative site required a second intervention in 2.4% of patients; life-threatening risk was one in a thousand [6]. In the long term, 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. After removing the herniation under the microscope and completely freeing the nerve, seeing the patient’s debilitating arm pain disappear while they are still in recovery is one of the most rewarding moments in my 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 serious complications are rare. Temporary swallowing difficulty and hoarseness are most common and resolve within weeks in most patients [5, 6].

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 Sexual Activity and Sports?

Gentle exercise such as walking can start the next day. Waiting approximately 2 weeks before resuming sexual activity is recommended. Swimming and light abdominal/back exercises are allowed in week 4; strenuous and contact sports are planned 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 brain, nerve and spine surgery.

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 – Brain, Nerve and Spine Surgeon
• ⚠️ Medical Disclaimer: This page is for information only; consult your doctor for diagnosis and treatment.