Cervical disc replacement uses an artificial disc to replace a diseased disc in the neck. The artificial disc is an alternative to using plates, bone grafts, and screws, in which the diseased disc is removed and the remaining discs are fused together. The space between the vertebrae may have become too narrow, causing pain, numbness or weakness. During cervical disc replacement, an incision is made in the front or side of the neck, the diseased disc is removed, and the artificial disc is placed in the empty disc space. General anaesthesia is used. This procedure is often done for patients who have cervical disc herniation that did not respond to previous treatments.
Who is a candidate?
Patients typically are those who have significant cervical disk degeneration that cause noticeable symptoms such as neck pain, neck stiffness, headache, pain and weakness of the shoulders and arms, and arm numbness. With age, cervical disks collapse, most often by age 60, but only some people experience debilitating symptoms that impact quality of life. Patients typically have failed to improve their quality of life after extensive nonsurgical treatment.
Who is not a candidate?
Patients who have active infections or who already have had a cervical disc fusion performed are not good candidates for cervical disc replacement, which is only approved for use alone. Additionally, those with significant abnormal motion or instability at the affected level of the spine should not consider cervical disc replacement as an option for treatment.
Prior to undergoing cervical disc replacement, a complete evaluation made first by traditional diagnostic methods should be undertaken. The final decision is typically made by an orthopedic physician with the aid of an arthroscopic examination. Before surgery, you should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior. You may need to stop taking blood thinner medication (e.g. Warfarin). You will likely be asked to stop eating or drinking the night before the surgery.
Patients are usually discharged the day of the procedure or the morning following the procedure. Depending on the surgeon, you may be asked to wear a surgical collar that immobilizes your neck for up to a week following. Most symptoms associated with cervical disc degeneration immediately improve, but may decrease gradually over time. For any major pain or discomfort during the initial recovery period, you will have prescribed pain medication. Follow your orthopedic surgeon’s postoperative instructions and attend any follow-up visits, which can confirm proper positioning and function of the disc replacement. Most patients will be able to return to light desk work 1-2 weeks postoperative, with a full recovery and complete resumption of normal activities taking up to 6 weeks for those whose jobs involve manual labor.
As with any surgery, there are risks of complications related to infection, damage to nerves and blood vessels, bleeding and blood clots, or adverse reactions to anesthesia. However, incidences of these complications are extremely rare. Complications specific to cervical disc replacement can also very occasionally lead to revision surgery. Swallowing difficulty has been commonly reported, and may persist for a prolonged amount of time and require follow-up treatment. Spontaneous fusion of the cervical disc across the disc replacement can also occur, but does not require revision surgery.
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