Some spine surgeons may prefer the posterior approach (from the back of the neck) for a cervical discectomy. This approach is often considered for large soft disc herniations that are lateral to (to the side of) the spinal cord.
The general procedure for the posterior cervical decompression (microdiscectomy) surgery includes the:
- A small incision is made in the midline of the back of the neck.
- The para-spinal muscles are elevated off the spinal level that is to be approached.
- An x-ray is done to confirm that the surgeon is at the correct level of the spine.
- A high-speed burr is used to remove some of the facet joint, and the nerve root is then identified under the facet joint.
- An operating microscope is then used for better visualization.
- The disc will be directly under the nerve root, which needs to be gently mobilized (moved to the side) to free up the disc herniation.
- There is usually a plexus (network) of veins over the disc that can obstruct visualization if they bleed.