【Major points】

1. Cervical nerve repair surgery is to decompress and repair the injured spinal cord through a microscope.
2. Cooperate with active rehabilitation after operation to improve the function of damaged nerves.
3. If you are taking medications that needs to be taken daily, please inform your doctor in advance.
4. Pay close attention to wound care, drainage tube cate, correct wearing of neck collar, change position and precautions for postoperative activities.
   
   

What is Cervical Neuro-Regeneration Surgery?
The traditional spinal surgery involves decompression and fixation of vertebral bodies outside the spinal cord, while the cervical nerve repair surgery is to open the spinal dura and use a microscope to decompress and repair the injured spinal cord.

Why is this surgery needed?
By using new medical technology to repair damaged cervical nerves, so that the scope of spinal cord injury can be controlled and will not continue to expand. At the same times, with active rehabilitation treatment, the nerve function can be restored and improved, so as to achieve the goal of nerve repair.

What should I prepare before surgery?
During the outpatient clinic, medical staff will assist patient to complete relevant examinations, including spinal series X-Ray, CT or MRI, electromyography, sensory and motor evoked potentials, urodynamic and other neurological related examinations. During hospitalization, medical staff will continue assisting patient to complete surgery-related examinations, including: ECG, chest X-ray and blood test, etc.

1. During the preoperative meeting, the doctor will explain the procedure, purpose, and complications of the surgery to the patient and family. Afterwards, the patient shall fill in the operation consent, anesthesia consent, blood transfusion consent and payment consent.
2. Prepare a suitable neck collar according to the doctor's instructions for daily activities after surgery.
3. The doctor will mark the surgical site before surgery, please do not wash it off.
4. If you have problems with constipation and have no bowel movement for several days, please tell the staff to have an enema to help you empty your bowels before surgery.
5. If you are taking anticoagulant medication or medications that needs to be taken daily, such as antihypertensive agents, please inform your doctor in advance to evaluate whether you need to take them.
6. Please avoid eating or drinking after midnight before surgery.
7. On the morning of the surgery, the patient will change into the surgical gown. Also remove glasses (including contact lenses), dentures, nail polish, accessories and jewelries.
   
   

What should I pay attention after surgery?

1. After surgery, the patient will have wound drainage, such as intravenous catheters, urinary catheters, etc. All these drains will be removed when the condition of patient is stable. Do not remove the tube by yourself as this may cause injury.
2. After returning to the ward, if the patient does not experience nausea or vomiting, and has normal bowel movements. You can drink water first and then eat normally if there is no discomfort.
3. For postoperative wound pain, the doctor will prescribe analgesics to relieve pain.
4. The patient must change position with turning sheet every two hours to prevent pressure injuries.
5. The neck collar needs to be used immediately after the operation. The nursing staff will guide you on the correct way of wearing the collar. The length of time to wear the collar is determined by the doctor, usually will require at least three months.
6. You should start bedside joints range of motion on the first day after surgery.
7. Please keep bed rest after surgery. Get out of bed as directed by your doctor. The nursing staff will assist the process.

Home care considerations

1. Keep the wound clean and dry. If there is redness, swelling, heat, severe pain or discharge, return to the hospital immediately.
2. Stitches will be removed around 7 to 10 days after surgery. If the patient was diagnosed as Diabetes Mellitus, the stitches removal will be depending on the healing condition. After stitches removed, Steri-strips could be put on to avoid scar formation.
3. Bowel training: A high fiber diet, medications, abdominal massage, anus stimulation and enema can maintain and promote defecation.
4. Bladder training: Adjust the duration of intermittent catheterization according to the patient's bladder capacity and residual urine volume. If the residual urine volume is less than 100 ml within two weeks, or the ratio of self-urination to residual urine is less than 3:1, catheterization can be stopped. It will be based on the results of the urodynamic examination. The doctor will perform renal function and urodynamic tests as needed by the patient.
5. Training for motor and sensory function:
   1. weeks 0-2: Massage the lower limbs on both sides and perform passive movement of all joints to maintain the range of motion of the hip, knee and ankle joints
   2. weeks 2-4: Increases passive range of motion, accompanied by active joint movement. Train the patient's bladder and defecation function
   3. weeks 4-8: Continue active movement of joints. Strengthen four limbs and keep range of motion accordingly. At this stage, patients can arrange rehabilitation programs at the clinic.
   4. months 2-12: The patient continues to undergo rehabilitation in the hospital near home, and is followed up by the neurological repair outpatient clinic every month. The physician conducts neurological examination, neuroelectral physiological examination, and bladder and colorectal function examination as necessary to evaluate motor function.

1. Gharooni, A. A., Kwon, B. K., Fehlings, M. G., Boerger, T. F., Rodrigues-Pinto, R., Koljonen, P. A., Kurpad, S. N,. Harrop, J. S., Aarabi, B., Rahimi-Movaghar, V., Wilson, J. R., Davies, B. M., Kotter, M. R. N., & Guest, J. D. (2022). Developing novel therapies for degenerative cervical myelopathy [AO Spine RECODE-DCM Research Priority Number 7]: Opportunities from restorative neurobiology. Global Spine Journal, 12(1_suppl), 109S-121S. https://doi.org/10.1177/21925682211052920
2. Patek, M., & Stewart, M. (2023). Spinal cord injury. Anaesthesia & Intensive Care Medicine. https://doi.org/10.1016/j.mpaic.2023.04.006
   
3. Shah, M., Peterson, C., Yilmaz, E., Halalmeh, D. R., & Moisi, M. (2020). Current advancements in the management of spinal cord injury: A comprehensive review of literature. Surgical Neurology International, 11, 2. https://doi.org/10.25259/SNI_568_2019