From an engineering perspective, the cervical disc is an amazing mechanical structure. It can absorb a large compressive load while providing range of motion between the bones and neck. Over time our discs become less flexible and disc degeneration can become a reality; which is due to aging, rapid wear, an injury, or genetic predisposition. With disc degeneration, the shock absorbers (i.e. discs) become less flexible and pain can occur (e.g. arm pain, arm weakness, numbness, or neck pain) . Although pain can be treated with nonsurgical therapies, surgery should be considered when conservative treatment fails to provide relief.
Surgical Treatment Options for Cervical Disc Replacement
In cases that are resistant to nonsurgical treatments, a surgical intervention is required. One option is a procedure called Anterior Cervical Discectomy and Fusion (ACDF). Discectomy literally means “cutting out the disc.” Once the disc is removed, it is replaced with a bone graft and fused together.
During an ACDF procedure, a spacer bone graft is inserted into the open space to prevent the vertebrae from rubbing together. This graft serves as a bridge between the two vertebrae to create a spinal fusion. Metal plates and screws are then used to fix the bone graft and vertebrae into place. The body will naturally heal as new bone cells grow around the graft. And after 3 to 6 months, the two vertebrae should be fused together as one solid piece of bone.
Another option is a cervical disc replacement. In this process, an artificial disc is inserted into and takes the place of the unhealthy disc. Instead of a bone spacer, accompanied by plates and screws, an artificial device is placed between the vertebrae that facilitates motion similar to the natural cervical spine. This device is often composed of three parts: two metal plates and a plastic insert in the middle. The plates have teeth on the top and bottom to help hold the plates to the vertebrae while the plastic insert is made to move as you move your neck.
Post Surgical Outcomes
Following fusion surgery, patients must be immobilized for a period of time while the vertebrae heals. Over time, a percentage of fusion surgery patients have seen complications around the five-year mark where they experience deterioration of other discs above and below the original point of surgery. While this surgery is most commonly done to treat cervical herniated disc, it is also commonly done to remove bone spurs and to alleviate symptoms with cervical spinal stenosis.
Cervical disc replacement, on the other hand, is much faster with fewer complications and patients have returned to work within a few days. The disc replacement device preserves more normal neck motion and patients are able to reclaim a wider range of head and neck movement after surgery. Leading to increased movement and a better quality of life. It also prevents increased stress in the spine and may protect the nearby vertebrae from enhanced degeneration over time.
Every patient is unique and the best way to determine appropriate treatment is to be examined by a spine specialist. New technology provides the patient options and Dr. Dan Hanson is up-to-date on the advancements in spine care to better serve his patients. Request a consultation to learn more.