What is cervical myelopathy surgery?

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.

Your doctor makes a cut (incision) in the skin over the spine. Special tools are used to do the surgery.

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 still feel stiff and sore for several weeks.

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 physical therapy and home exercises.

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. The doctor then closes the incision with stitches. You will have a small scar on your neck or back. It will fade with time.

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

• You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
• Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
• Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
• Ask your doctor when you can drive again.
• Avoid riding in a car for more than 30 minutes at a time for 2 to 4 weeks after surgery. If you must ride in a car for a longer distance, stop often to walk.
• Try to change your position about every 30 minutes while you sit or stand. This will help decrease your neck and back pain while you heal.
• Your time off from work depends on how quickly you feel better and on the type of work you do. If you work in an office, you likely can go back to work sooner than if you have a job where you are very active. Talk with your doctor about your work needs.
• You may have sex as soon as you feel able, but avoid positions that put stress on your neck or back or cause pain.

Diet

• You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Drink plenty of fluids (unless your doctor tells you not to).
• You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Be safe with medicines. Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• If you think your pain medicine is making you sick to your stomach:
  • Take your medicine after meals (unless your doctor has told you not to).
  • Ask your doctor for a different pain medicine.

Incision care

• If you have strips of tape on the cut (incision), leave the tape on for a week or until it falls off.
• Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
• Keep the area clean and dry.

Exercise

• Do neck and back exercises as instructed by your doctor.
• Your doctor may recommend that you work with a physical therapist to improve the strength and flexibility of your neck and back.

Other instructions

• Follow your doctor's instructions about wearing a brace or collar to support your neck.
• To reduce stiffness and help sore muscles, use a warm water bottle, a heating pad set on low, or a warm cloth on your neck. Do not put heat right over the incision. Do not go to sleep with a heating pad on your skin.