Introduction
Disc replacement, also known as total disc arthroplasty (TDR) or artificial disc replacement (ADR), is a surgical procedure that involves removal of an injured or degenerated spinal disc and replacing it with a prosthesis, an artificial disc implant.
Cervical discs are present between the bones of your neck called the cervical vertebrae and act as cushions or shock absorbers in your neck. Cervical disc replacement is surgery performed in the neck region to replace a damaged disc with an implant to relieve pain.
Indications
Cervical disc replacement is recommended when non-surgical treatments such as medications, spinal injections, and physical therapy are unsuccessful in the treatment of cervical disc disease.
Cervical disc replacement is contraindicated for:
- Children
- Osteoporosis
- Active infection
- Spine instability
Surgical Procedure
Cervical disc replacement is performed under general anesthesia.
- You will be placed in supine position, face up.
- A 1 to 2-inch incision is made in the side of your neck.
- This will expose the damaged and protruding disc, and any associated bone spurs.
- Your surgeon may use a surgical loupe magnifying glass or a surgical microscope to assist in complete removal of the disc and to perform spinal nerve decompression.
- This will help relieve the pressure off the spinal cord and nerve roots.
- After the disc is removed, the gap that is created between the two bones is filled by carefully placing the implant between the cervical vertebrae and securing it using biocompatible cement or screws.
- Live X-ray called fluoroscopy is used to visually guide your surgeon in proper positioning of the disc implant.
- After completion, the incision is closed.
- Some surgeons may place a drain into the wound that is removed soon after the surgery.
Post-Operative Care and Recovery
You will be discharged on the same day or the next morning following cervical disc replacement surgery.
- Your surgeon may recommend a cervical spine neck immobilization brace during the healing process.
- You may experience symptoms such as numbness, pain and weakness which should improve gradually.
- For intense pain, your surgeon will prescribe you pain medications.
- You will be scheduled for follow-up checkups and X-rays to monitor your recovery and to assess implant positioning and functioning.
- Most patients who undergo cervical disc replacement can return to light work within a week or two after the surgery.
- Complete recovery may take around six weeks.
Risks and Complications
Cervical disc replacement may be associated with the following risks and complications:
- Nerve injury
- Bleeding
- Difficulty swallowing
- Improper implant positioning
- Implant dislocation
- Need for revision surgery
Advantages and Benefits
Cervical disc replacement prevents further degeneration of the cervical vertebrae. It also offers the following benefits:
- Preserves neck motion
- Relieves neck and arm pain
- As it does not require bone grafting, the risk of non-union or non-fusion of spinal bones is removed
- Reduced irritation of the esophagus and swallowing difficulties
- Quicker recovery
Summary
Cervical disc replacement is a surgical procedure to treat painful cervical disc disease not responding to conservative treatment measures. The surgery involves removal of an injured or degenerated cervical disc and replacing it with an artificial disc implant. The procedure is performed to help relieve chronic neck pain. Common side effects include pain and swelling which will be minimized using medications prescribed. Cervical disc replacement offers relief from chronic neck pain and allows you to get back to your daily activities.
