Cervical disc replacement
The natural cervical intervertebral disc is an amazing mechanical structure from an engineering perspective. It has the ability to absorb a large compressive load while still providing an impressive range of motion between the bones in the neck.
The intervertebral discs of the neck are fibrous layers of tissue between the bones of the neck (vertebrae) which form the neck joint/s. These discs are able to provide shock absorption, movement and when healthy also provide the space needed for the nerve roots to exit the spine. Unfortunately, with injury or age the discs can lose these qualities. In some cases, the pain from the discs and joints of the neck and sometimes the associated nerve roots (which may be compressed due to the discs losing height) causes significant disability. In these cases, a cervical disc replacement may be offered.
Duplicating the natural disc's form and function with a synthetic (or artificial) disc is challenging. However, several artificial cervical discs have been developed and are available as a surgical option. These devices insert between two vertebrae in the neck to replace the damaged disc and restore a more normal disc height.
What does surgery involve?
You will not be able to eat for eight hours prior to surgery although you will be able to drink small amounts of water up to four hours before.
The surgeon will make an incision in the front of your neck to safely remove the injured disc and any associated bone spurs which may be compressing the spinal cord or nerve roots. Once the gap between the bones has been created the disc replacement device will be carefully inserted in to the space. Once positioned perfectly, the disc replacement device may be secured with screws or may have a press fit anchor to the adjacent bones. The incisions are closed with stitches or adhesive strips.
When will I recover?
Recovery from the anaesthetic is rapid and you will be awake very soon after the operation although you may feel drowsy for an hour or two. You will be allowed to go home either the same day or the following day after your surgery.
Depending on your individual circumstance and the type of disc replacement device used, you may be required to use collar to restrict your neck movements for 1-2 weeks. Once a check x-ray has been conducted, you will need to start intensive physiotherapy which may continue as long as six months.
What risks should I know about?
A cervical disc replacement is a commonly performed and generally safe procedure but there are some potential complications you should be aware of. These affect a very small percentage of patients. Your surgeon will speak to you about the risk of you developing any complication before the procedure.
- Infection can occur although our theatres have ultra-clean air operating conditions keeping infection rates to the minimum.
- Blood clots are possible and are more common in patients with some pre-existing medical conditions. However, again they affect a very small percentage of patients and have well established treatments including aspirin.
- Damage to the spinal cord or nerve roots around the neck may cause ongoing pain, numbness and in some cases disabling levels of weakness and
- The neck may remain stiff and painful and/ or pre-existing neurological symptoms such as pain, numbness and weakness in the arms may persist.