Neck disc replacement
As the Consultant Orthopaedic Spinal Surgeon at Circle Reading, Mr Chris Brown sees patients with all manner of neck and back issues, requiring a variety of treatment methods. Here, Mr Brown talks us through the process of undergoing one such method - a Neck Disc Replacement.
A physical injury or trauma to the neck, as well as general wear and tear through ageing, can cause one or more of the discs in your neck to start pushing on the surrounding nerves. Not only can this cause severe pain in your neck, it can trigger pain in your shoulder and/or arm, as well as a numbness or tingling sensation in these areas. Sometimes you may even experience some muscle weakness in those upper limbs. Clearly, medical intervention is needed to help you maintain normal movement.
For an initial consultation, diagnostic scans may not be required, as I will usually be able to diagnose the issue through a physical examination, but if surgery is considered at a later date, I may request an MRI at a follow-up appointment to get a closer look at the cervical nerve root in your neck. During the physical exam itself, I will check your range of movement, extending the neck to see if it triggers any symptoms in your arms and shoulders, as well as checking your reflexes.
If your symptoms have persisted beyond four-to-six weeks, and a combination of rest and physiotherapy has proved ineffective, I would likely look at a surgical approach, assuming you are otherwise in good health. As an alternative to a spinal decompression procedure, I can perform a neck disc replacement, inserting an artificial disc implant into your neck that mimics the function of the affected disc.
Previously, neck fusion used to be the only option, which whilst being effective in dealing with the damaged disc and resulting pain, meant that neck movement was often rather restricted due to the fusing of the remaining discs. Not only does fusion surgery take a lot longer to heal from, a disc replacement often allows the full range of movement you had prior to your symptoms occurring, as well as avoiding other complications such as the bone graft not properly fusing. By taking out the degenerated disc, you also reduce the chance of the other surrounding discs developing degenerative disease.
Early on, I like to set expectations, particularly regarding expected outcomes. It is important for me to find out what a patient’s main concerns might be, so I will spend some time with you to ensure you feel at ease about the operation and understand the various risks that go hand in hand with such a procedure. Aside from the usual risks of general anaesthetic (which include a blood clot, stroke, and heart attack), there is the risk of infection (although this is minimal due to the ultra-clean operating theatres provided by Circle), as well as potential nerve damage. There is also the possibility that despite the operation, your pain and weakness may continue with little improvement. This may sound disconcerting, but the reality is that these issues are very rarely encountered, and if you are otherwise fit and healthy prior to surgery, there is a great chance of success.
The disc replacement is performed under general anaesthetic and usually requires a one-night stay in our hospital. I make a small cut in the front of your neck, removing the deteriorated disc causing the nerve compression, cleaning up any bone spurs along the way. With the disc removed, this creates a gap to allow me to place the artificial disc at its normal height, relieving the affected nerves, before securing the disc to the adjacent bones.
Due to the need for only a small incision, patients often have a very rapid recovery. As the incision is made at the front of your neck, some patients will have a sore throat at first and may experience some difficulty speaking and swallowing, but this should pass relatively quickly. During your rehabilitation period, you will work closely with our dedicated physiotherapy team, and they will guide you in finding the right balance between physical activity and rest.
I will see you for a follow-up consultation roughly two weeks after your surgery to assess your progress and your condition, such as checking that the incision site is healing well. A full recovery depends on various factors, but many of my patients begin to engage with a physiotherapy programme after four weeks, and those with more physical jobs are usually able to return after six weeks. Your expected recovery times will be discussed at each stage so you are kept well-informed.
With a high success rate of restoring normal movement and range of motion for my patients, a neck disc replacement could be the best solution for you. If you are uncertain about the procedure or have any queries at all, please don’t hesitate to book a consultation with me; through a simple examination I can determine whether or not it would be beneficial for you, and advise if there are other treatments available. Together with our multi-disciplinary team at Circle, we can set out a realistic path towards your recovery.