Cervical Disc Replacement

Your cervical spine is made up of seven bones called cervical vertebrae that stack on top of one another to form the neck region. The cervical disks are the cushions located between the cervical vertebrae. They operate as shock absorbers, allowing the neck to move freely.

The top half of your spinal cord can also pass via a protective tunnel formed by your cervical spine. This section of your spinal cord contains the spinal nerves that provide sensation and movement to your upper body.

When the space between your vertebrae gets too small, a portion of your vertebrae or your cervical disk may press on your spinal cord or spinal nerves, producing discomfort, numbness, or weakness.When these symptoms do not improve with nonsurgical therapy, disk surgery may be indicated.

Cervical disk replacement surgery consists of removing a defective cervical disk and replacing it with an artificial disk. Before this treatment became accessible, the damaged disk was removed and the vertebrae above and below were fused together to prevent mobility.

Goals for Cervical Artificial Disc Replacement.

Before deciding to undertake cervical artificial disc replacement (ADR) surgery, also known as cervical disc arthroplasty, it is critical to understand what the procedure will accomplish. The primary aims of cervical ADR include:

1. Relieve nerve compression. When a disc herniates or starts to deteriorate and collapse, the nerve roots (and occasionally the spinal cord) have less capacity to function.This can cause persistent discomfort, tingling, numbness, and/or weakness spreading from the neck down the arm. Clearing the injured disc and installing an artificial disc seeks to alleviate pressure on any pinched nerves, allowing them to recover and function properly. If the spinal cord was previously compressed, reducing pressure on it may aid in the resolution or prevention of additional symptoms, such as difficulty with coordination, walking, and/or bladder or bowel control.
2. Maintain mobility at the repaired spinal level. Natural biomechanics can be better maintained across the cervical spine when the injured disc is replaced with an artificial disc. An artificial disc can assist preserve motion, but it cannot produce or improve motion.The cervical spine's range of motion is unlikely to improve following disc replacement surgery.
3. It should be emphasized that any symptom reduction obtained by cervical disc replacement surgery is mostly attributable to nerve root irritation and/or spinal cord compression. As a result, cervical disc replacement surgery is rarely indicated for individuals with neck-only problems.

The advantages of artificial disc replacement (also known as arthroplasty) include:

1. Preserves natural neck movement
2. Reduces stress on surrounding discs
3. Requires no bone graft
4. Allows for early neck motion following surgery.

Disc repair versus spinal fusion.

Cervical disc replacement has better outcomes than fusion. Anterior cervical discectomy and fusion (ACDF) is the gold standard for surgical treatment of herniated disc.ACDF consists of removing a damaged disc and introducing a bone graft to fuse the two vertebrae into one solid bone. ACDF and arthroplasty appear to be equally beneficial in alleviating symptoms caused by disc herniation.

Surgeons believe that arthroplasty can lower the likelihood of neighboring segment disease. This can happen when a fusion puts additional tension on the moveable discs above and below it. Over time, this additional stress might deteriorate the nearby discs, resulting in new difficulties and eventual surgery.

Long-term studies are needed to demonstrate that disc replacement minimizes the risk of neighboring segment disease. Consult with your surgeon about whether fusion or disc replacement is right for you.

Who is a candidate?

You may be a candidate for cervical disc replacement

1. A herniated or degenerative disc.
2. Significant hand or arm weakness
3. Arm pain greater than neck discomfort
4. Symptoms not improving with physical therapy or medication
5. Healthy facet joints (no arthritis)

You might not be a candidate if:

1. Facet joint arthritis or ankylosing spondylitis
2. Osteoporosis
3. A prior spinal fusion at an adjacent level
4. Instable spine, spondylolisthesis, or abnormal curvature of the neck (scoliosis/kyphosis)

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Arthroplasty can cure herniated discs, which occur when the elastic core bulges or ruptures through a weak spot in the wall (annulus). This substance pushes on a nerve, causing pain and swelling.

Degenerative disc refers to the drying and shrinking of discs with age. As the disc thins, the vertebrae rub and compress the nerves.

A surgical choice

Most ruptured discs recover after a few months of nonsurgical therapy. If you are a candidate for an arthroplasty, the surgeon will discuss your alternatives. Before you make a decision, consider all of the risks and advantages. In general, younger persons (ages 18-60) have better results and reap the most benefits from artificial disc replacement.

What are the results?

Make careful to discuss the most recent results of the disc device your surgeon advises.

According to studies, cervical artificial disc replacement (ADR) effectively relieves arm discomfort in more than 70% of patients. Cervical ADR has demonstrated at least equal efficacy to ACDF in terms of neck pain, arm discomfort, patient function, and satisfaction, with no increase in surgical complications. These findings are based on five to ten years of follow-up in FDA-approved trials.