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Cervical Disc Replacement

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The pre and post-surgical images of the artificial cervical disc replacement.
Source : Midwest Orthopaedics at Rush, LLC

Artificial Cervical Disc Replacement (ADR)

A herniated disc leaves little room for nerve roots as it begins to degenerate and collapse. The constricted space becomes a major source of pain, numbness, and tingling that radiates to your arm. The purpose of removing the damaged disc and replacing it with an artificial disc, recommended by the best disc replacement surgeon, is to alleviate the pressure on compressed nerves, allowing them to heal and function properly. However, replicating the natural disc's shape and function with an artificial disc poses a considerable challenge.

Fortunately, advanced medical technology has made it possible to develop several artificial cervical discs to treat disc problems causing chronic neck pain and weakness.

Our spine doctors may suggest cervical artificial disc replacement (C-ADR) as an alternative to anterior cervical discectomy and fusion (ACDF) for certain spinal conditions. Cervical disc surgery in young individuals, especially fusion surgery, can increase the incidence of side effects like neck stiffness or adjacent segment disc disease. Putting in an artificial disc can overcome these limitations and restore normal cervical spine (neck) movement, thus improving the overall outcome.

When You May Need ADR

In the event of diminished space between the cervical vertebrae caused by cervical disk degeneration or wear and tear, the cervical disc may require replacement. However ADR is not suitable for advanced degeneration.
When the cervical disc collapses and bulges with age. Generally, individuals between the ages of 18 and 60 experience more favorable outcomes and derive greater benefits from undergoing artificial disc replacement surgery.
When your pain, discomfort and other symptoms do not subside despite medication or physiotherapy.
Pre-Surgical Care For ADR
What to Expect During Cervical Artificial Disc Replacement Surgery
Post-Surgical Care

Every surgery requires a comprehensive study of your medical history, physical condition, and predisposition to medication or other allergies. Our doctors may recommend the following pre-surgical measures before your ADR operation:

  • Diagnostic studies such as x-rays. MRI or CT scans, or Discograms to assess your condition.
  • Refrain from eating or drinking anything for a certain amount of time prior to your surgery.
  • Permission to take your prescribed medication with a few sips of water.
  • Request for information if you are on blood thinners like Coumadin, Aspirin, Ibuprofen, etc. Your doctor will ask you to temporarily stop the medication before the procedure.
  • Quit smoking or using tobacco in any other form to mitigate cardiac and lung issues. Avoiding smoking considerably reduces the success rate of your surgery.

The C-ADR is a minimally invasive surgical procedure. Here’s a glimpse of what to expect:

  • You will be positioned on your back since the approach is through the front of your neck.
  • Our anesthetist will administer general anesthesia to make the process completely painless.
  • Our surgeon will make a small incision in the front of your neck to access the affected disc using a live X-ray imaging device.
  • Once located, the disc and other intrusive bone fragments compressing your spinal nerves are removed.
  • The pressure on the adjacent nerves is relieved by surgically restoring the disc space to its normal height.
  • Using the X-ray device, the artificial disc is placed into the designated space and attached to the lower and upper vertebrae.
  • The incision is closed with sutures once the disc is placed.

Your hospital stay post ADR will last for a day or two unless you experience any difficulties, in which case you may require an extra couple of days.

  • Your doctor may advise you to walk a few hours post-surgery. Take gentle and relaxed measures to ensure your safety while moving, and refrain from stretching your neck by bending it backwards.
  • You might benefit from using a brace or soft collar temporarily after the surgery to assist your neck muscles.
  • Follow your physiotherapist’s advice on performing routine activities without straining your neck.

Understanding Artificial Cervical Disc Replacement

The artificial cervical disc replacement is more beneficial than a spinal fusion because it:

  • Enables a better range of neck motion than fusion, which restricts your movement after the neck bones are fused.
  • Negates the need for additional spine surgery primarily because it does not restrict your range of motion. Fusion surgery, on the other hand, restricts movement and adds to the stress on the bones above and below the fusion area.
  • Promotes faster healing and recovery. In a disc replacement, there are no bones that need to fuse together, meaning you can return to activities and the things you love to do sooner. On the other hand, a fusion surgery may require at least an eight to twelve weeks recovery period.

As with all surgical procedures, the ADR also has certain complications. Since this surgical procedure is relatively new, there is minimal information about the associated risks. The most common complications one may encounter with ADR are:

  • The risk of infection, medication allergies, and excessive blood loss are common in most surgeries.
  • Temporary swelling in the throat may restrict your ability to speak or swallow.
  • Excessive bone formation may occur outside the muscles or ligaments as a result of surgical trauma. This is called Heterotopic Ossification, which may lead to reduced neck motion.

Consulting your surgeon at Spine 360 about the pros and cons of disk replacement surgery versus conventional cervical spine procedures may help alleviate your concerns.

ADR is not the best option if you have:

  • Advanced spinal degeneration, ligament ossification, or facet joint degeneration conditions like Ankylosing Spondylitis or Osteoarthritis. Also, artificial cervical discs require FDA approval at three adjacent spinal levels instead of the existing approval for use at two adjacent spinal levels.
  • Bone weakening conditions such as Osteoporosis or bone infections may compromise the stability of the disc.
  • Bone instability due to a prior neck surgery.
  • Allergy to the prosthetic disc material.
  • Severe spinal deformity
  • Any underlying medical conditions that inhibit recovery or compromise the safety of the process.

To maintain your health and prevent neck pain, we recommend the following measures:

  • Maintain proper posture while lifting heavy objects, sitting, standing, and sleeping.
  • Indulge in an exercise routine recommended by your physiotherapist.
  • Establish an ergonomic workstation for your convenience.
  • Maintain a positive attitude towards life and learn to cope with stress.
  • Quit unnecessary habits like smoking, alcohol, etc.
A happy doctor with a stethoscope.

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