Cervical discs acts as a shock absorbers between the vertebras of the cervical spine (neck). Discs damaged by trauma or degeneration can cause pain. If part of the disc slips out of its normal position can cause pressure on the central spinal cord or on the surrounding nerves roots. Disc disruption and degeneration can cause neck pain or neurological symptoms that may include pain, numbness or weakness that radiates from the neck to one or both arms. Cervical disc replacement is a surgical procedure that requires removing a damage or degenerated cervical disc and replacing it with an artificial disc.
Person who is suffering from the following problems are considered as a suitable candidate for the cervical disc replacement:
• Persistent neck pain or neck stiffness
• Possible neurological symptoms that may radiate into arms.
• Weakness of shoulders, arms, hands or legs
• Numbness in the arms
• Not responding to non-surgical treatment such as anti-inflammatory medications, physiotherapy or epidural steroid injection
• No previous neck surgery
• Not having any active infection
• No allergies to the implant material
• Not suffering from osteoporosis
Most of the patients suffering from herniated disc, degenerated disc or arthritis in the neck do not require surgery and can get relief from non surgical methods such as anti-inflammatory drugs, physical therapy or cold/heat therapy within 4-6 weeks.
Surgeon will make a treatment plan based on the health condition of the patient, history, reaction to general anesthesia, will ask patient to quit smoking before surgery till specific period of time after the surgery. He/she may also perform some tests such as X-rays, MRI or CT scans. Patient should stop taking non-steroid anti-inflammatory medicines a week before after discussing it with the doctor and should inform if taking insulin in case the patient is diabetic.
During the surgery, patient will be given general anesthesia and the patient lies face up on a special surgical bed. Surgeon will make an incision on one side of the patient’s neck to gain the access to the spine. Surgeon will carefully move aside the trachea (windpipe), esophagus (stomach tube) and blood vessels that lie in front of the spine. Then the damaged disc is exposed and removed with the help of surgical equipments. This is called discectomy. Disc replacement is carefully placed into the position between the vertebrae, after preparing the disc space. This realigns and enlarges the opening to relieve pressure from the nerves. Fluoroscopy can help in the proper positioning of the disc replacement implant. After placing the artificial disk, incision will be closed. This surgery will improve the symptoms such as pain, numbness and weakness within hours of the surgery. Patient can be discharge the same day or next day and most patients can go back to normal light routine work within a week or two.
Post surgery, doctor may prescribe some pain medicines and antibiotics, may also suggest brace in some cases. He may also ask patients to avoid strenuous activities such as repeated bending, lifting, twisting or any other athletic activities. But may suggest physical therapy as a part of the post treatment plan to improve the patient’s strength and increase mobility by using safe body movements that protects the spine.
Disc replacement surgery is a safe procedure but all surgeries carry some potential risks and complications such as:
• Unexpected blood loss
• Infection in the wound
• Reaction to anesthesia
• Nerve damage
• Fluid leakage from the spine
• Change in voice
• Breathing difficulties
• Difficulty in swallowing
• Broken or loose artificial disc
Patient should immediately contact doctor if he/she gets fever, wound starts leaking blood or pus (that can consists bacteria), difficulty in urination, or there is new or increased neck or arm pain, numbness or weakness.