Private consultation · ICEM · Hospital La Salud, Valencia
Cervical Herniated Disc Surgery Without Fusion in Valencia
Endoscopic, minimally invasive surgery for a cervical herniated disc: a minimal incision, no plates or screws when the case allows, preserving the mobility of your neck.
+2,500 patients treated · 10+ years in spine surgery · Direct care from your surgeon
When neck pain that radiates down the arm is a cervical hernia worth operating on
A cervical herniated disc isn’t always felt in the neck. Often the most bothersome symptom is pain that travels down the shoulder and arm, tingling or numbness in the hand, or loss of grip strength. This happens because the herniated disc presses on a nerve root at the level of the cervical vertebrae, usually at C5-C6 and C6-C7.
Most of these hernias improve without surgery. That’s why the first step is always a well-managed conservative treatment. Surgery only makes sense when the pain doesn’t ease despite treatment, when weakness appears, or when there are signs the nerve is suffering.
If you’re still not sure whether your hernia needs surgery, that’s exactly what we resolve in a first consultation or a second opinion. We don’t operate on hernias that don’t need it.
What endoscopic cervical surgery is and how it differs from the traditional operation
The classic operation: anterior cervical discectomy and fusion (ACDF)
The most common cervical surgery in Spain is anterior cervical discectomy and fusion, known as ACDF. It is approached from the front of the neck, the whole disc is removed and the two vertebrae are fused with a plate and screws. It relieves the nerve compression, but at a cost: that level of the neck stops moving forever, and the extra load can shift to the neighbouring discs over the years.
The endoscopic approach: same hernia, minimal incision, no fusion
Endoscopic cervical surgery pursues the same goal —to take the pressure off the nerve— but through a minimal incision, working with a camera that shows the hernia at high magnification. When the case allows, only what compresses the nerve is removed (the hernia or the bony spur closing the foramen) without fusing the vertebrae, preserving the disc and its mobility.
Dr. Vilatela performs this surgery via a posterior biportal approach (UBE/ESUBE technique): through two small portals he works with an endoscopic camera to free the nerve root (posterior cervical foraminotomy/discectomy) without fusing the vertebrae. It is the same minimally invasive biportal technique he already applies in the lumbar spine, now in the cervical spine, and it is always performed with intraoperative neurophysiological monitoring, which watches the spinal cord and nerve roots in real time for maximum safety.
You can see the general framework of the technique on the endoscopic spine surgery page.
No plates or screws: why preserving mobility changes the long-term result
The real difference isn’t the scar. It’s what your neck is left with afterwards.
| Aspect | Classic operation (ACDF) | Endoscopy without fusion |
|---|---|---|
| Access | Anterior approach, the whole disc is removed | Two minimal portals with an endoscopic camera |
| Vertebral fusion | Yes — plate and screws | No — no plates or screws |
| Mobility of the level | Lost forever | Preserved |
| Neighbouring discs | Possible overload over the years | Less overload |
| Collar | More restrictive | Soft, about 48 hours |
| Hospital discharge | Longer stay | Within 24 hours |
For patients who have been advised to fuse, this is the key question that deserves a second opinion. And if endoscopy were not indicated in your case, there is still cervical disc replacement (arthroplasty), which also preserves mobility without fusion.
Which cervical hernias can be operated on by endoscopy (and which cannot)
Being honest about this is part of the job: not every cervical hernia is a candidate for endoscopy.
✓ A good candidate for the endoscopic technique
Soft hernias compressing a nerve root, with radiculopathy (pain radiating to the arm, tingling or weakness) that doesn’t ease with conservative treatment, and foraminal stenosis of one or two levels.
Open surgery or arthroplasty is better
Myelopathy with broad spinal-cord compression, instability, heavily calcified hernias or involvement of several levels: fusion (ACDF) or cervical disc replacement may be more appropriate.
The only way to know which group you’re in is by assessing your MRI. We do that in consultation, with your images in front of us.
The operation step by step and day-by-day recovery
The day of surgery
The procedure is performed under general anaesthesia and with intraoperative neurophysiological monitoring throughout. Through two small portals the nerve is freed under endoscopic vision, without fusion when the case allows. Discharge is within 24 hours.
Recovery: collar, driving and returning to work
As there is no fusion, no rigid collar is needed: a soft collar for about 48 hours is enough. From there, the return to activity is progressive according to your recovery, starting with light activity; physical effort and work are resumed somewhat later, following the consultation’s guidance.
Second opinion: have you been advised to fuse the vertebrae (arthrodesis)?
It’s one of the most frequent reasons for consultation. You’ve been told the neck must be fused with a plate and screws, and before taking that step you want to know whether another option exists.
It’s worth reviewing. In a second opinion we look at your MRI, I explain whether your case is a candidate for a fusion-free approach and, if it isn’t, I tell you frankly why fusion is still the most sensible choice. No pressure and without selling you a technique that doesn’t suit you.
Why have surgery with Dr. Vilatela
Private consultation in Valencia, no insurance and no waiting lists
Price and financing of cervical hernia surgery
The quote is set after the assessment, because it depends on the affected level and the technique needed in your case. We work with a closed quote (no surprises) and offer pricing and financing options.
Frequently asked questions about endoscopic cervical hernia surgery
Can a cervical hernia be operated on without fusing the vertebrae?
Yes. When the case allows, the cervical hernia is operated endoscopically by removing only what compresses the nerve, without fusing the vertebrae, preserving the disc and the mobility of the neck. Not all hernias are candidates: we assess it with your MRI.
What is endoscopic cervical hernia surgery and how does it differ from the traditional operation?
It is a minimally invasive surgery: through two small portals and with an endoscopic camera the compressed nerve is freed. Unlike the classic operation (anterior discectomy with fusion, ACDF), which removes the disc and fixes the vertebrae with a plate and screws, the endoscopic approach aims to preserve the disc and the movement.
Will I need a collar after cervical hernia surgery?
No rigid collar is needed. After fusion-free surgery a soft collar for about 48 hours is enough.
How long is the recovery and when can I return to work and driving?
Discharge is within 24 hours. The return is progressive according to your recovery: first light activity and, later, physical effort and work, always following the consultation’s guidance.
Is cervical endoscopy an alternative to plates and screws (arthrodesis)?
Yes, in suitable cases. If you’ve been advised to fuse the neck with a plate and screws, fusion-free endoscopy —and, when that isn’t possible, cervical disc replacement— can preserve mobility. A second opinion before fusing is worthwhile.
What are the risks of endoscopic cervical spine surgery?
Like any surgery it is not free of risks, but being minimally invasive the damage to the tissues is lower. The procedure is performed with neurophysiological monitoring throughout, watching the spinal cord and nerve roots in real time. In consultation we explain the specific risks of your case.
Can I avoid cervical hernia surgery with physiotherapy?
Many cervical hernias improve without surgery, which is why the first step is always a well-managed conservative treatment. Surgery is only considered when the pain doesn’t ease, there is weakness or the nerve is suffering.
Which cervical hernias is the biportal endoscopic (UBE) technique for?
Above all soft hernias compressing a root and causing pain radiating to the arm (radiculopathy/brachialgia), and foraminal stenosis of one or two levels. It is the same biportal technique Dr. Vilatela applies in the lumbar spine.
Do you work with medical insurance?
No. It is a private consultation. We do not work with Asisa, Adeslas or other insurers. In exchange: no waiting lists and direct contact with the surgeon who will operate on you.
Request a private appointment or a second opinion
If you have neck pain radiating down the arm, or you’ve been advised to fuse the neck and want another opinion, get in touch.
Instituto de Columna Mediterráneo (ICEM) — Hospital Casa de la Salud, Valencia.