Most patients with a slipped disc causing arm symptoms only (radiculopathy) respond to conservative management within ~3 months. This usually composes of regular analgesia and physiotherapy. If the pain does not settle surgery should be considered. In cases of myelopathy an operation should be considered as soon as possible! Damage to the spinal cord is often not reversible. The main aim is to prevent deterioration.
Anterior cervical discectomy or cervical disc replacement can address radiculopathy and myelopathy. Often it is the surgical treatment of choice for patients who have not responded to conservative treatment. A laminectomy is also indicated for myelopathy and posterior foraminotomy for radiculopathy. In rare cases, a corpectomy might be necessary. There are several factors which will influence the decision which procedure is chosen. The differences are explained in the ’operations‘ section.
The vast majority of patients undergoing surgery for radiculopathy are cured or significantly improve after surgery. None of the operations obviously change the nature of the underlying disease (i.e. wear & tear). In cases of myelopathy, the main aim is to prevent deterioration although symptoms often improve to some degree, in particular the stiffness of hand and walking. In some cases of myelopathy, patients continue to deteriorate despite successful surgery due to the damage that has been done. Unfortunately, the recovery of the spinal cord is often slow and unpredictable and might take many months.