This promising new procedure is a boon for all those suffering from severe and intractable neck pain. It has revolutionized the approach used for treating patients with severe longstanding cervical spondylitis, whiplash injuries, cervical disc prolapse, offering them a better quality of life. Also known as artificial disc replacement, this technique is fast becoming popular amidst surgeons and patients alike because of its excellent results. It is considered superior to cervical spine fusion surgeries as it maintains normal neck motion post operatively and ensures early return of patient to normal activities. In this procedure a stainless steel disc with a ball in trough design is inserted between the affected cervical vertebrae. This helps to simulate natural neck movements. The patient stays in the hospital for 1-2 days and resumes work in 45 days.
Working Anatomy of Cervical Spine
The cervical spine consists of 7 cervical vertebrae named C1, C2, C3, C4, C5, C6, C7 with shock absorbing intervertebral disc in between them. These discs allow for the smooth rotating and bending movements of the cervical spine. With age these discs lose their water content and get compressed between the vertebrae which may lead to herniation of disc contents. Along with this there is wear and tear of the vertebrae causing formation bony outgrowths known as (osteophytes). The prolapsed disc can compress the spinal cord within the spinal canal (myelopathy) or the exiting nerve roots at the intervertebral foramina (lateral openings between each vertebral pair) causing radiculopathy (radiating pain in the arm).
Objective of the Procedure
The cervical segments C4- C5, C5-C6, C6-C7 are more vulnerable to disc prolapse and spondylitis due greater mobility at these joints. Disc prolapse results in reduction of intervertebral distance which causes pressure on the exiting nerve roots at intervertebral foramina. Disc replacement surgery aims at reducing the symptoms of degenerative joint disease. Replacing the damaged disc with an artificial implant or prosthesis, restores the normal distance between the two vertebrae and relieves the pressure on the nerve roots.
Indications for this procedure
Cervical disc replacement is an effective treatment for people suffering from disc herniations, and/or neck/arm pain from myelopathy or radiculopathy, failed cervical fusion, patients with multilevel degenerative disease, and patients with segmental disease after fusion.
Contraindications ( Reasons not to have this operation)
Patients with cervical spine instability, significant facet joint damage or infection, osteopenia, osteoporosis, autofusion, unnaturally straight spine (kyphosis) may not be considered good candidates for this surgery.
Details of the procedure
The operation is done from the anterior (front) aspect of the body. The patient is placed on his/her back on the Jackson spine table. An incision is made through the skin and thin muscles on the front of the neck. The blood vessels, trachea (windpipe), and the esophagus are moved to the side for clear view of the cervical spine. The disc to be replaced is identified using the fluoroscope. The fluoroscope is an X-ray machine that allows the doctor to actually see an X-ray image while doing the procedure. The surgeon removes the fragments of damaged disc and shaves the osteophytes. The disc space is then distracted to normal height and the artificial disc is inserted into the prepared space with the help of a fluoroscope. Finally the prosthesis is checked by moving the spine in various positions. An X-ray is done to reconfirm the location and fit of the new disc.
World Class Technical Expertise at SpineNeuroSurgeryIndia.com affiliated Spine hospitals
Our Spine hospitals in India are fully equipped with state of the art diagnostic centre and fully-equipped operating room with specialized equipment, such as the Jackson Spine Table, to undertake such specialized procedures, Advanced Digital X-ray, MRI and CT scan facilities. The Super specialist spine surgeons have tremendous experience and have undergone specialized training in the world’s best spine surgery hospitals in USA, UK and Australia.
Post operative Recovery and Rehabilitation Period
The patient stays in the hospital for 1-2 days and resumes work in 45 days post operatively. Avoid bending neck backwards. A brace or soft collar may be recommended after the operation to support the neck muscles. Physical therapy may be prescribed 1-2 weeks after surgery which has to be done on out patient basis. The therapy will initially start with pain relieving modalities such as ice, electrical stimulation to reduce pain followed by gentle active exercises. Gradually gentle stretching, strengthening and endurance exercises to the neck muscles are introduced. The therapist gives instructions on how to maintain the neck postures during various tasks of daily living. This is followed by a home exercise program.
- Artificial disc surgery has lesser chances of requiring a revision surgery, compared to spinal fusion surgery
- Normal neck motion can be maintained
- Unlike the spinal fusion surgery the adjacent spinal discs in case of cervical disc replacement don’t have to bear the extra stress.
- Eliminates the need for a painful bone graft
- Recovery time is quicker compared to the fusion surgery.
- Lesser number of patients need a hard collar following the cervical Disc Replacement surgery