This post was written by Micah Smith, MD, orthopedic spine surgery, Ortho NorthEast.
If you are experiencing discomfort in your neck, a motion-preserving orthopedic surgery could be the solution you need to get relief.
Symptoms and diagnoses
Often, patients who have pain in their neck or pain/numbness going down their arm, are experiencing the discomfort common with cervical stenosis or a disc herniation.
Treatment
We will typically begin with conservative treatment options, such as physical therapy, medicine and injections, which can often be very beneficial.
If those are not successful in relieving the discomfort, and the pain is worsening over time, it could be time to explore surgery.
Surgical option
Your spine surgeon will base your surgical intervention on imaging of the area of concern. Some factors, such as the presence of advanced arthritis, can impact whether or not a patient is a good candidate for cervical a disc replacement versus a disc fusion.
Compared to a cervical disc fusion, which can lead to subsequent surgery, as other levels get involved, a cervical disc replacement helps the individual maintain range of motion. It prevents neighboring levels in the neck from being impacted.
The surgical approach is the same as a fusion. The surgeon goes in through the front of the neck, and moves the trachea and esophagus over. If it's a herniated disc, we find that piece of disc material that's broken off and remove it. If it’s stenosis, we remove the bone spurs.
Whether is a disc herniation or bone spurs, we create a nice big opening for the nerves, to make them nice and happy. In both procedures we have to remove the disc to do this, we have to put something back in so it doesn’t collapse back down on the nerve. So we place a disc replacement in there to keep the space open for the nerve. The replacement is typically two metal plates with a bearing surface or plastic piece in the middle to help maintain the motion and mobility.
Risks
The risks of a cervical disc replacement are the same as those of surgery in general–including infection, blood clots and bleeding. Also, because we are working around the nerves, there is an extremely low risk of neurologic issues or weakness. People typically wake up with a sore, scratchy throat, but overall, it’s very safe and has an extremely reliable outcome.
Benefits
One of the benefits of doing a disc replacement over a fusion is that it usually lasts a lot longer. Patients tend to have less complications long term and maintain mobility.
At Ortho NorthEast, we’ve been involved in four studies involving disc replacements. Because of these studies and those done by other spine surgeons, we now have good data from 10, 15 and 20 years post-operative. These results show us that outcomes are incredibly successful years later. And I can speak from experience! I’ve had a cervical disc replacement and am 2 years out…and I feel great!
Recovery
Cervical disc replacement procedures are usually done outpatient, meaning the patient can go home the same day as the surgery. They can then slowly return to their regular activities as tolerated. They will need to do some physical therapy as well. Most patients are back to their normal routine by six weeks after the procedure.
Outcomes
In general, people don’t need surgical revisions as often as patients who have cervical fusions do. That doesn’t mean they will never need another cervical disc replacement, though. There are seven discs in the neck, so there’s always a chance they’ll require additional surgeries.
If you have neck pain, it’s worth exploring whether cervical disc replacement is a good solution for you. To schedule orthopedic care in Allen County, call Ortho NorthEast at 260-484-8551 or schedule an appointment online here, or visit this page to find orthopedic care outside of Allen County.
