What is surgery for cervical myelopathy?

Surgery for cervical myelopathy (say "my-uhl-OP-uh-thee") removes any tissues that are pressing on the spinal cord. Tissues can include bone, ruptured discs, and ligaments.

The surgery can be done from the back or the front of the neck. If surgery is done from the front, small pieces of bone or small plates and screws will be used to hold the spine in place after the tissue is removed. This is called fusion. If surgery is done from the back, a fusion may or may not be done at the same time.

Your doctor makes a cut (incision) in the skin over the spine where the pressure on the spinal cord is. He or she puts special surgical tools through the incision. Your doctor removes any tissues that are putting pressure on the spinal cord. He or she then closes the incision with stitches. You will have a small scar on your neck or back. It will fade with time.

Surgery is done to stop the pressure on the spinal cord. This may help with pain and numbness and may improve movement. It will also help prevent more damage. Some people notice that their symptoms improve very soon after surgery. But your neck and upper back may feel stiff and sore for several weeks after your surgery.

Most people stay overnight in the hospital. You will probably be able to return to work or your normal routine in 4 to 6 weeks. In some cases, the doctor may recommend a rehabilitation program after surgery. This may include physiotherapy and home exercises.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take about 1 to 2 hours.
• When you wake up, you will be lying flat on your back. You may have a plastic or foam collar around your neck.

Going home

• Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.