Dr. Shaad Bidiwala, M.D.
Best Doctors: Neurosurgery 2009,2010,2011,2012
What is a herniated cervical disk?
The intervertebral disks are cartilaginous cushions between the vertebra of the spine. When these wear either from normal aging or prematurely after a traumatic situation, they can dry out, break, and herniate, or move out of their natural place, compressing the spinal cord, the nerve roots, or both.
What symptoms do patients with herniated cervical disks have?
Symptoms of a cervical disk herniation depend on how bad the situation is. Patients may begin having neck pain early in the course of their disease, as the disk wears out, and the vertebra begin moving abnormally with respect to one another. As a disk herniates, and compresses the nerve roots going to the arms, patients may have severe pain, numbness, and weakness in the arms and hands. In severe cases, herniated disks can compress the spinal cord, leading to difficulty walking and even paralysis.
What options are available to treat herniated disks of the cervical spine?
Except for in severe cases involving severe pain, weakness, paralysis, conservative measures should always be attempted first. Rest, nonsteroidal anti-inflammatory medications, and heat are useful in mild cases. Physical therapy for massage and cervical traction are often useful because they can help pull herniated disks back into their correct place between the cervical vertebrae. Epidural steroid injections are helpful in soothing inflamed nerve roots as a disk herniation heals on its own. In my experience these conservative measures solve the problem in over 50% of cases.
“ACDFs are typically very successful operations, with most patients reporting improvement in their symptoms within days of surgery, if not immediately.”
What does surgery involve?
Surgery for a herniated cervical disk typically involves a 1-2 hour procedure called an anterior cervical discectomy and fusion, or ACDF for short. An incision is made on the front of the neck, and the spine is exposed at the appropriate level. I use a microscope and specialized microinstruments to remove the degenerated disk and take the pressure off of the spinal cord and nerve roots. In the place of the disk, I typically place a bone-filled cinderblock, or “cage” made out of a thermoplastic called polyether ether ketone, or PEEK for short. In order to hold the cage in place, it is common practice to use a titanium plate with screws going into the vertebra above and below the disk that is removed. In cases where the spinal cord is severely compressed, I typically use neuromonitoring in order to make sure that the spinal cord is not being injured ACDFs are typically very successful operations, with most patients reporting improvement in their symptoms within days of surgery, if not immediately.during the most delicate parts of the surgery.
What should I expect after surgery?
Neck pain, difficulty swallowing, and hoarseness are common symptoms for patients to have for a few days after surgery, however these usually resolve quickly. Patients typically stay in the hospital for a day or two and are able to return to non-strenuous work a few weeks later.
Dr. Shaad Bidiwala practices at Texas Neurosurgery. His areas of expertise lie in the surgical treatment of herniated disks in the lumbar, thoracic, and cervical spine, as well as tumors of the brain and spine. He graduated summa cum laude with bachelor’s and master's degrees in electrical engineering and then went on to finish medical school at the University of Louisville. He completed his residency training in neurological surgery at the University of Kentucky and is board certified in neurosurgery by the American Board of Neurological Surgeons. His engineering background fuels his keen interest in using the latest innovations in neurosurgery, including minimally invasive spine surgery, artificial disk replacement, computer image-guided brain surgery, and deep brain stimulation for Parkinson’s disease and essential tremor. Dr. Bidiwala has privileges on BUMC's Novalis, CyberKnife, and Gamma Knife radiosurgery facilities for the incisionless treatment of brain tumors, cerebrovascular lesions, and trigeminal neuralgia.