Cervical Disc Herniation Surgery

How Dr. Salman Falak performs the operation

The usual operation is anterior cervical discectomy and fusion, or ACDF. It is done under general anaesthesia through a short incision in a skin crease on the front of the neck. Dr. Salman Falak reaches the spine by moving the windpipe and the food pipe gently to one side and the large neck vessels to the other, along natural planes, so very little muscle is cut. The damaged disc is removed piece by piece under the microscope, and any bone spur or loose fragment pressing on the nerve or the cord is cleared.

The empty disc space is then filled with a small cage or a piece of bone graft, which holds the two neck bones apart and lets them fuse into one solid segment over the following months. A thin plate and screws are often added to keep the level still while this happens. Whether fusion is needed, and which implant is used, depends on the level, the quality of the bone, the number of discs involved and how stable the neck is, and Dr. Salman Falak explains his recommendation before surgery. The operation itself is not long for one level, and the hospital stay is usually a night or two.

Benefits and what to realistically expect

Arm pain from a pinched nerve root usually improves quickly once the pressure is off, often within days. Tingling and numbness follow more slowly, and weakness takes the longest, because the nerve fibres themselves have to regrow. When the spinal cord was compressed, the main aim is to stop further loss. Some function returns in many patients, but long-standing cord damage may not fully recover, which is why early surgery matters in those cases.

The incision on the front of the neck heals into a fine line along a skin crease. Most patients are surprised by how little neck pain the operation causes compared with the arm pain they arrived with. A fused level loses a small amount of movement that most people do not notice in daily life. Dr. Salman Falak sets out these expectations honestly before anyone agrees to surgery.

Who is a candidate, and when surgery is not advised

Candidates are patients whose MRI shows a disc herniation at the level that matches their symptoms, and who have either arm pain that has not settled with a fair trial of medicines and physiotherapy, or weakness in the arm or hand. A third group, those with signs of spinal cord compression, is advised to act without long delay.

Surgery is not advised for neck pain alone without arm symptoms or cord signs, because a fusion does not reliably cure neck pain. It is also held back when the MRI changes are mild or at a different level from the symptoms, or when pain is improving week by week. Patients who are not fit for general anaesthesia are treated for that problem first. Dr. Salman Falak is clear about this at the first visit: many patients with a neck disc never need an operation.

Before surgery: tests and preparation

An MRI of the cervical spine is the key test, and it can be sent on WhatsApp from anywhere in Punjab for a first opinion. Dr. Salman Falak examines the arms and the legs closely, because the examination tells him whether the nerve root or the cord is involved. Neck X-rays, sometimes taken bending forwards and backwards, show how stable the neck is and help with the choice of implant. A CT scan is occasionally added to look at bone spurs.

Routine blood tests and an ECG are done, and the anaesthetist reviews the patient. Blood thinners are paused on advice and diabetes is brought under control. Smokers are asked to stop, since smoking interferes with fusion. Patients come fasting on the day and bring all old scans and reports.

Recovery and follow-up

Most patients sit up and walk on the evening of surgery or the next morning. A sore throat and some discomfort on swallowing are common in the first days, because the food pipe was held aside during the operation, and soft food helps while this settles. A soft collar may be given for comfort and support in the early weeks. Whether it is needed depends on the implant used and the level, and Dr. Salman Falak tells each patient how long to wear it.

Discharge is usually within a day or two. Light walking starts at once. Driving waits until the neck turns comfortably and the collar is off, and heavy lifting and overhead work are avoided until the fusion is well under way. Office work often restarts within a few weeks. The first review is at the Lahore OPD, and an X-ray is taken at later visits to check the fusion. Patients from other cities can take later follow-ups by video consultation, with an X-ray done locally and sent on WhatsApp, or at the Friday OPD in Gujranwala and the Tuesday OPD in Phool Nagar.

Where the surgery is done

Cervical disc surgery is performed in Lahore. Dr. Salman Falak consults at Sharif Medical City Hospital in Jati Umra on Raiwind Road, and also at Life Hospital in Bahria Town and Doctor Care Hospital in Al Kabir Town. The operating hospital is agreed with the patient. He holds an OPD at Gujranwala Medical Complex on G.T. Road every Friday and in Phool Nagar on Tuesdays. Patients from Faisalabad, Sargodha, Sialkot or further afield usually begin with a video consultation. They travel to Lahore once for the operation and go home with a follow-up plan that does not need repeated journeys.

Risks and how they are kept low

ACDF is a well-established operation with known risks that are uncommon. They include a hoarse voice from irritation of the nerve to the voice box, swallowing difficulty that lasts longer than usual, wound infection, bleeding in the neck, injury to the nerve root or the spinal cord, failure of the bones to fuse, and extra strain on the disc above or below the fused level in later years. Serious neurological injury is rare. Patients are told about every one of these before they sign consent.

Dr. Salman Falak keeps the risks low by operating only when the MRI and the examination agree, by working under the microscope with careful handling of the cord and the nerve, by using X-ray to check the level and the implant position, and by asking smokers to stop, since smoking is a known cause of fusion failure.

Related conditions and procedures

Neck problems are one part of the spine work Dr. Salman Falak does, and the full range of operations, from the lower back to the neck, is listed under spine surgery. The microscope used in this operation is the same tool described on the microscopic spine surgery page. Patients whose arm symptoms turn out to come from the wrist, with numbness in the thumb and first fingers at night, may have carpal tunnel syndrome instead, and that is assessed at the same clinic. If you are unsure whether your symptoms come from the neck, a video consultation is a sensible place to start.