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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 is:
Possible risks and complications of a posterior approach for cervical discectomy include:
Advantages and disadvantages over an anterior cervical discectomy
The major advantage of approaching a cervical disc herniation through a posterior approach is that a fusion need not be performed. This preserves the normal motion of the cervical spine, and may provide for a shorter healing time.
Although avoiding a fusion may sound desirable, the posterior approach has many disadvantages. Because the spinal cord is in the way, visualization of the disc space is limited and typically only a disc herniation that is lateral (off to the side of the spine) can be approached. Also, by not doing a fusion anteriorly, the disc space is not distracted and the associated collapse that happens with a disc herniation can continue and place pressure on the nerve in the foramen (where the nerve exits the spine). Lastly, since the disc is not removed completely, it can re-herniate in the future.
In general most surgeons prefer approaching the cervical spine anteriorly when possible because:
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