Cervical Disc Replacement Surgery
Cervical disc replacement surgery is a spine surgery for the neck that replaces a herniated or degenerative cervical disc with an artificial one. As your cervical discs serve as cushions between the vertebrae in your neck, a damaged or herniated disc may cause symptoms such as significant pain, numbness, weakness, neurological problems, and even issues with your balance and use of your hands. Cervical disc replacement surgery can give you relief and improve your quality of life while keeping your neck moving in a physiologic and natural way.
Why Cervical Disc Replacement Surgery?
- Eliminates pain, burning, numbness, and weakness caused by cervical disc herniation
- Corrects disc-related nerve compression that affects neurological function
- Replaces a degenerative disc with a fully mobile artificial disc, allowing the spine to function properly
- Enables natural motion that may slow degeneration of other cervical discs
- Innovative approach provides a viable surgical alternative with distinct and proven advantages over traditional fusion surgery
- Return to work and activities is faster than in traditional fusion surgeries.
Candidates for cervical disc replacement typically meet the following criteria:
- Generally good overall health
- Full skeletal maturity (most patients are between ages 20 and 70)
- Confirmed cervical disc disease (degeneration of one or more discs)
- Symptoms such as pain, tingling, numbness, and weakness in the neck, upper back, arms, and/or hands
- Neurological deficits or signs of nerve compression, such as difficulty with balance, using hands, walking, and bladder function
- Nonsurgical treatments have failed to relieve symptoms long-term
- No significant underlying cervical spinal deformity.
Individuals with a herniated, injured, or degenerative cervical disc may need cervical disc replacement to correct the following symptoms:
- Pain, potentially significant and often radiating from the neck to the upper back and one or both arms
- Burning sensation or “pins and needles” in the neck, upper arms, or back
- Stiffness in the neck
- Numbness or weakness that travels down one or both arms
- Neurological problems such as trouble using your hands, balancing, walking, or controlling your bladder (in more severe cases)
- The surgery is typically performed under general anesthesia.
- Most patients can go home on the day of surgery. But even in larger, multilevel cases, patients generally go home on the day following surgery.
- The procedure is fast, often lasting less than an hour.
- After sterilizing the treatment area, a small incision (1 to 2 inches) is placed on the front left of your neck in a skin line to allow for cosmetic closure
- The vertebrae and cervical disc are gently exposed through a natural window between two muscles.
- The damaged cervical disc is removed, along with any disc fragments or bone spurs pressing on the nerve root or spinal cord.
- The disc space is restored to its normal height to eliminate nerve compression.
- Using live fluoroscopy (x-ray imaging) to ensure perfect fit, the artificial disc is securely placed in the disc space.
- Your spinal cord and nerves are monitored continuously during the case to allow for safe and real-time feedback.
- The incision is closed with all sutures under the skin and a small dressing is applied.
- A neck collar is placed to support the spine during healing.
- Recovery in the surgery center or the hospital will be carefully monitored before you are discharged home.
Cervical disc replacement offers several advantages over traditional fusion surgery, including:
- Preserves range of motion
- May protect against accelerated degeneration of adjacent discs, or degenerative disc disease (fusion can cause greater stress on the remaining vertebrae)
- Does not require any bone grafting
- The initial recovery is much faster (up to 1 week of soft cervical collar support rather than 4 to 6 weeks after fusion surgery)
- No restrictions with return to sports or hobbies.
Frequently Asked Questions
Cervical disc replacement may be recommended if you have a damaged or degenerated cervical disc. As shock absorbers between the spinal bones, discs are subjected to significant use over a lifetime and can gradually degenerate. In addition, trauma or injury can cause sudden, unexpected damage to an otherwise healthy cervical disc. Discs can also become disrupted or slip out of place, which may lead to a variety of symptoms and permanently damage the disc. Cervical disc replacement surgery may be recommended for you if your symptoms have failed to improve with nonsurgical treatments such as physical therapy, medications, and/or spinal injections. Dr Pehler will discuss with you whether this treatment is a good option for your condition.
With fusion surgery, the damaged disc is removed, and the bones are fused together. This eliminates the associated pain and other symptoms, but because the vertebrae are fused, it leads to slightly limited motion and potentially greater strain on the adjacent discs. Cervical disc replacement, on the other hand, removes the herniated disc and replaces it with a functional artificial disc, thereby correcting symptoms while also enabling a natural range of motion.
Fortunately, data has shown that unlike hip or knee replacements, artificial discs in the cervical spine do not wear out over time, likely because they are subjected to far less stress than hip and knee joints.
There is proven track record data over 20+ years on cervical disc replacements. This is a reliable surgery that can provide patients with excellent outcomes.
The main risks with cervical disc replacement surgery using modern implants has little if anything to do with the replacement itself. Patients can experience a temporary sore throat, difficulty swallowing, and some minor neck pain due to the surgical approach in the front part of the neck.
The potential risks and benefits will be discussed with you at length prior to your procedure.
Immediately after the surgery, you will be taken to a recovery area for monitoring. Postoperative pain is minimal and can be treated with pain medications. You can resume eating your normal diet as soon as you have recovered from the anesthesia. Most patients are discharged home on the day of surgery or on the morning following.
At home, you are encouraged to move around (while avoiding strenuous activities) as soon as you feel up to it. Neurological symptoms can improve often immediately upon waking from anesthesia. Postoperative discomfort usually improves significantly within 2 to 3 days. You may need to continue wearing a neck support for up to one to two weeks, and you will be briefed by your surgeon regarding any other activity restrictions, suture removal, and requirements for physical therapy. Most patients can resume light work activities within 1 to 2 weeks and more strenuous labor within 3-4 weeks.