- The nucleus pulposus – the soft, gel-like center of the disc.
- The annulus fibrosis – strong, fibrous outer ring that surrounds and supports the nucleus pulposus.
Over time, discs can become dried out, compressed or otherwise damaged, due to age, genetics and everyday wear-and-tear. When this happens, the nucleus pulposus may push through the annulus fibrosis. Disc degeneration also may result in bone spurs, also called osteophytes. If disc or bone material pushes into or impinges on a nearby nerve root and/or the spinal cord, it may result in pain, numbness, weakness, muscle spasms and loss of coordination, both at the site of the damage and elsewhere in the body, since most the nerves for rest of the body (e.g., arms, chest, abdomen and legs) pass from the brain through the neck. Similar symptoms, however, may occur suddenly if the disc nucleus dislodges acutely and causes nerve root compression, a condition referred to as a herniated disc.
When non-surgical therapies such as exercise, pain relievers, physical therapy and/or chiropractic care fail to provide relief from your symptoms, your neurosurgeon may recommend surgery.
Used to treat
- cervical radiculopathy, myelopathy or both with the presence of disc herniation and/or bone spurs.
- Your symptoms did not improve after conservative treatment measures,
- You require treatment at only one cervical level.
To determine whether cervical artificial disc replacement surgery is the right treatment for you, your neurosurgeon will perform a physical exam and other diagnostic testing, such as a spinal X-ray; magnetic resonance imaging (MRI), computed tomography (CT) scan, myelogram and/or a bone scan.
It is important that you discuss the potential risks, complications, and benefits of cervical artificial disc replacement surgery with your doctor prior to receiving treatment, and that you rely on your physician’s judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.
The Procedure
The goal of cervical artificial disc surgery is to remove all or part of a damaged cervical disc (discectomy), relieve pressure on the nerves and/or spinal cord (decompression) and to restore spinal stability and alignment after the disc has been removed.
Through a small incision made near the front of your neck (a surgical approach called the anterior approach) your surgeon will:
- Gently pull aside the soft tissues – skin, fat and muscle – as well as the trachea, or windpipe, to access the cervical spine
- Expose the area where disc fragments and/or bone spurs are pressing against the neural structures (nerve roots and/or spinal cord);
- Remove the disc and bone material from around the neural structures to give them more space (discectomy and decompression);
- Insert and secure the artificial disc into the intervertebral space, using specialized instruments;
- Ease the soft tissues of the neck and other structures back into place; and
- Close the incision.
Knowing what to expect during your procedure can help you face your surgery with confidence. Your doctor can give you additional details about the procedure specific to your condition.
Recovery
Your neurosurgeon will discuss with you a specific post-operative recovery plan to help you return to your normal activity level as soon as possible. Your length of stay in the hospital will depend on your treatment and physical condition. You typically will be up and walking by the end of the first day after the surgery. Your return to work will depend on how well your body is healing and the type of work/activity level you plan to return to. It is imperative that you follow instructions exactly to optimize your healing process.
Potential Risks or Complications
All procedures come with a certain level of risk. Your neurosurgeon will discuss with you the risks and outcome benefits with you prior to surgery.
Potential risks associated with any surgery include anesthesia complications, blood clots, allergic reactions and adverse effects due to undiagnosed medical problems. A potential complication associated inherently with artificial disc replacement surgery is an allergic reaction to the implant material. If you have any questions regarding your surgery as our staff or your neurosurgeon.
