Several factors are considered before deciding that cervical disc replacement is the best treatment option versus fusion surgery or conventional decompression. The benefits and risks of cervical disc replacement can only be understood with in-depth, long term and numerous studies, and this fact is the biggest consideration. Presently, much of the data on the cervical discs are based on theories.
In general, the circumstances that indicate that there may be a need for cervical disc replacement are similar to the indications for fusion surgery or discectomy. The cervical disc of the patient must be symptomatic, which may be resulting to pain, numbness or weakness in the arm with some amount of neck pain. Such symptoms may be caused by osteophytes that are causing compression on the spinal or the surrounding nerves and/ or a herniated disc.
Ususally, a patient must meet certain defined criteria before he or she will gain admission to a clinical trial. For instance, the patient must have not undergone prior surgery on the neck and he or she must go through four up to six weeks of non-operative trial treatments, typically including different forms of physical therapy and medications. Overall, the patient must be considered as a good candidate for surgery.
Cervical disc replacement procedure
The standard procedure in a cervical disc replacement surgery involves an anterior approach, which is the same approach used for a fusion surgery or discectomy. The surgeon will completely remove the disc that is affected including any bone spurs or impinging fragments of the disc. Then, then surgeon raises the disc space to its normal height to aid in the decompression on the nerves. This step is critical because worn out discs usually shrink, and may result to pinched nerves in one’s neck. Lastly, the surgeon implants the artificial disc into the disc space with the use of x-ray or fluoroscopy.
Like all other surgeries, cervical disc replacement has its potential risks including blood loss, infection, and paralysis or nerve injury. While these risks are very serious, they occur very rarely. Additionally, the artificial disc will naturally wear out over time and small particles of it may cause some reaction with the body. However, laboratory studies have found that there over a period of ten years, there is only minimal wearing out of the disc and that the body tolerates the material well.
Cervical disc replacement has benefits over a fusion surgery, one of which is the elimination of the risks involved with using a bone graft from the patient’s hip or the risk of infection when the procedure uses “cadaveric” bone graft. Obviously, the patient does not have to go through the healing process of a bone graft with a cervical disc replacement. This procedure allows a more normal motion for the neck and the patient is able to perform more types of activities for longer after the surgery.