What is Cervical Disc Replacement?
Cervical disc replacement surgery, also known as total disc arthroplasty, entails removing a damaged or degenerated intervertebral disc in the neck and replacing it with an artificial disc. This procedure resembles cervical discectomy (the removal of a diseased disc) and fusion except that the space created by that procedure is not fused, but rather filled with a disc replacement device. This device is usually composed of a metallic material that moves and functions like an actual disc.
What does it treat?
When the cervical discs, which serve as the cushions between the vertebrae in the neck, become damaged or degenerated, they can cause pressure on the spinal cord or spinal nerves. This can cause pain, weakness or numbness that emanates from the area of the problem disc and can radiate to the limbs.
Herniated discs and degenerative disc disease are two common conditions for which a cervical disc replacement is a potential treatment. Cervical disc replacement surgery is meant to relieve the symptoms by replacing the damaged disc and restoring function.
Who is a Candidate?
Those who meet the following criteria are good candidates for cervical disc replacement.
- Conservative measures are not working. These measures usually include nonsurgical treatments such as ice, heat, medications, physical therapy and therapeutic injections. If these measures cease to provide relief, or are tried for approximately four to six weeks and result in insufficient improvement, surgery may be indicated.
- Cervical disc disease is confirmed. If imaging (MRI or CT scan with contrast dye) reveals degeneration of a disc(s) and evaluation confirms this is the cause of symptoms.
- Symptoms include radiopathy or myelopathy. In addition to pain, cervical disc disease often causes numbness and weakness in the arms and hands. This is called cervical radiculopathy, which occurs when a nerve root in the cervical spine is damaged or inflamed. Cervical disc degeneration can also cause myelopathy, related to pressure on the spinal cord, which causes above symptoms also occurring in the legs, as well possible difficulty with coordination or walking, or loss of urinary or bowel control.
- The candidate is in good health. This ensures that the person can tolerate surgery and is likely to have a good recovery, with the benefits outweighing the potential risks. The skeleton must be mature, so minimum age is usually 20 and ranging to 70.
- Cervical disc replacement (arthroplasty) is indicated. For the most part, cervical disc replacement be performed instead of anterior cervical discectomy and fusion. However, there are cases in which arthroplasty is not an option.
How Is a Cervical Disc Replacement Performed?
The patient is put under general anesthesia for cervical disc replacement. Depending on the location of the diseased disc(s), a one- to two-inch horizontal incision is made on the side or front of the patient’s neck. The surrounding structures of the neck are carefully moved to provide access to the disc(s). The diseased or damaged disc is exposed and removed. This removal may include any bone spurs (osteophytes) that may have also developed.
Through the use of fluoroscopy or X-rays, the artificial disc is then sized and carefully inserted into the empty disc space between the vertebrae. The incision is then closed under the skin, using absorbable stiches. This outer skin is then closed with stitches that minimize any scarring.
After surgical dressing is applied to cover the incision, a special soft collar may be put on the patient’s neck in order to restrict neck motion. The patient is then taken to the recovery room.
What Is Cervical Disc Replacement Recovery Like?
Patients are often discharged the same day as surgery, or the following morning. A neck collar for immobilization and protection may be required. The doctor will provide guidelines on the length of time. General guidelines are that light activity can be resumed two to four weeks after surgery. By week four patients should be able to resume most of their activities, but resumption of heavier activity may require six to eight weeks.
If you have experienced a neck injury, request an appointment at Edison Spine Center. Our surgeons can diagnose the nature of your injury and recommend a cervical disc replacement or another treatment that is right for you.