Often a cervical disc will herniated off to the side of the spinal cord and compress the spinal nerve only. In that case, it is better to operate from the back of the neck, in the same way we do for a herniation in the lower back.

An incision about ¾ inches long is made vertically in the midline and the muscle on the side of pain is retracted away from the bone, exposing the joint between the two laminae beneath which the nerve is compressed. Using a binocular operative microscope that gives 3-D vision and that has coaxial illumination, one can magnify the “target” up to 20 times. Portions of the lamina above and below are then removed and the nerve is located just beneath. Under the nerve is a soft (sometimes with calcification called “hard disc”) disc fragment that can be easily removed. That’s all need be done. The muscle falls back to the midline and its coverings are pulled together with 2-3 stitches. Some stitches are placed just under the skin to bring that together and Steri-Strips or bioglue used to close the skin surface.

Local anesthetic is injected before closure and patients have minimal pain when they awaken. The buried stitches dissolve and don’t have to be removed. Patients go home the same day if they live near by.