The decision to perform the surgery with an anterior or posterior approach is made by the neurosurgeon. Factors such as neck hernia location and surgeon’s experience are effective in this decision.
For the front approach, the right side of the neck is usually used. After a horizontal incision of 4-5 cm is made, the subcutaneous tissue, the superficial muscle layer just below it, is passed and proceeded between the neck muscles until the jugular vein can be seen. In order to reach the spine, the jugular vein is taken to the outside, the esophagus and trachea to the inside, with special tools, and the anterior part of the neck spine is reached. X-rays are taken during the operation to determine the area between the vertebrae to be operated on and the operation site is checked. After this stage of the surgery, it is performed under the microscope. In this approach, prostheses are placed in place of the evacuated disc material to fix the adjacent two vertebrae in a way that preserves movement. After the bleeding control, the incision site is closed so that no stitches are needed and the operation is terminated.
In the case of neck hernia, posterior neck surgery is more limited. If the hernia is not in the midline and is at the mouth of the canal where the nerve root exiting the spinal cord enters to leave the spinal canal, then a posterior approach may be recommended.
After Neck Hernia Surgery
The patient is up and about two hours after the operation and is discharged after one night in the hospital. He can go home by sitting in the car, and can do his daily activities at home. Prosthesis patients are usually not given a neck brace, but patients for whom fusion is intended can be fitted with a neck brace for six weeks. However, while traveling by vehicle for the first three months, a neck brace is worn only during travel and care must be taken to ensure that the upper seat support, located behind the patient’s head, is at the same height as the patient’s head. The collar is removed while lying down. Care is taken to ensure that the bed and especially the pillow are suitable for neck health.
In the first days, there may be complaints such as pain, burning sensation and stinging at the incision site in the neck. In the following period, first of all, neck pain goes away. Problems such as numbness and tingling may take longer to pass. In the first week, there may be difficulty in swallowing and a feeling of being stuck in the throat. The problem is edema in the esophagus. For this reason, soft foods are preferred for the first three to four days. If hoarseness occurs, it is usually temporary, but rarely lasts for six months.
Before discharge, the first dressing of the wound is done and closed. On the fifth day, the patient can undress and take a bath. No need for stitches. If there is redness, swelling or discharge at the wound site, a doctor should be consulted.
Those working at desk jobs can return to their jobs after one month if they wish. However, those who do heavy work should rest for six weeks. In the first six weeks, no more than one kg of weight can be carried on the hand. It is very dangerous to drive for 6 weeks after the operation, especially driving with a neck brace. Short plane trips can be made, but long plane trips are not made in the first three months.
No contact sports activities are allowed for the first six months. Only walking is enough, the most recommended sport activity is swimming. After returning to normal daily life after four months, the exercise program given and swimming exercises are continued.
