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For many years, the gold standard for surgical treatment of certain painful neck conditions has been a procedure called anterior cervical discectomy and fusion. This surgery can effectively relieve pain, but it limits the patient’s range of motion and places more stress on the discs above and below the fusion.
Fortunately, today spine surgeons have the technology to perform cervical disc arthroplasty (replacement)–placing an artificial disc between two vertebrae in the neck.
"Cervical disc replacement can be an excellent option for active patients as it maintains motion and potentially decreases the long-term issues that come with fusion surgery,” says Dr. Seyed Babak Kalantar, MD, chief of the Division of Spine Surgery in the MedStar Orthopaedic Institute at MedStar Georgetown University Hospital and the Co-Director of MedStar Spine Center.
Not all spine surgeons have adopted this technology. Those who have find it to be a phenomenal treatment option for some patients with painful neck conditions such as cervical disc herniation. Here’s how it works.
"We can treat some neck-related arm pain with disc replacement. It can avoid a spine fusion." via @MedStarWHC
How does cervical disc arthroplasty work?
The cervical spine is the portion of the spine in the neck. There are six discs in the cervical spine that rest between the vertebrae, the bones that make up the spinal column. The discs are spongy and act as shock absorbers.
When there’s a problem with a disc, the spinal cord or nerves can be compressed or pinched. This can cause neck pain, along with arm pain, numbness or weakness.
Traditionally, when physical therapy and medication didn’t relieve the pain, the main surgical option was anterior cervical discectomy and fusion. That surgery involves taking the disc out and replacing it with a piece of bone, a metal plate and screws that over time would fuse the vertebrae and stabilize that part of the cervical spine. The surgery relieves pain, but patients lose some range of motion because there is no longer movement between the fused vertebrae.
“In cervical disc arthroplasty, instead of fusing vertebrae together, we replace the disc with an implant that mimics your normal disc motion,” says Dr. Oliver Tannous, Spine Surgeon at MedStar Orthopaedic Institute at MedStar Washington Hospital Center. “It basically functions as a joint that allows normal range of motion and reduces stress on the discs above and below.”
The FDA approved the first cervical disc implant in the U.S. in 2007, which allowed surgeons to replace one problematic disc. In 2013, the first device was approved to replace two adjacent problematic discs.
Who might benefit from this technique?
Cervical disc replacement can help people with conditions such as these if non-surgical treatments did not work:
- Cervical disc herniation
- Cervical radiculopathy
- Cervical spinal stenosis
- Degenerative disc disease
This procedure is typically performed on patients younger than 60. The main reason for this is because most people 60 and older have a fair amount of arthritis in the neck. Cervical arthroplasty doesn’t cure the arthritis, so the neck pain can remain. In these cases, traditional surgery is recommended.
Recovery takes days, not weeks
The most amazing part about this technique other than sparing range of motion is the short recovery period.
When a traditional fusion is performed, the patient may be in a brace up to 12 weeks. This immobilizes the neck to allow the fusion to take place.
But when a disc replacement is performed, motion should not be locked up for very long. Patients are typically put in a brace for a couple days to help with the swelling, but then should be out of the brace and going about their normal activities.
There are patients who had surgery on Friday and were back to work on Monday. Activity is not restricted too much – it’s usually up to the patient to do what he/she can tolerate. Don’t engage in extreme ranges of motion or participate in contact sports right away, but go about daily activities.
Those experiencing neck and arm pain due to disc herniation or cervical spinal stenosis may not need surgery at all. About 75 percent of patients get better using physical therapy, anti-inflammatory medications or steroid injections. It’s only after those options have been exhausted that surgery is discussed.
For those in that small group that needs surgery, cervical arthroplasty can be a viable alternative. This procedure provides pain relief without the frustration of losing range of motion in the neck.
Schedule an appointment online or call 855-788-6464 to talk to a doctor about whether cervical arthroplasty might be right for you.