Cervical discs aid people by providing essential movement and cushioning functions. If a cervical disc is damaged, artificial cervical discs can be used to replace these functions. These are specifically used when patients experience neck pain and/or pain originating from arm and shoulder nerves, which can be caused by cervical disc disease. Standard spinal fusion surgeries replace damaged discs with devices and aim to fuse vertebral bodies, creating one bone from two formerly independent vertebral bodies. Spinal fusion surgery can cause the discs above and below the fusion to degenerate in a condition called adjacent level disease. To alleviate such problems, artificial cervical discs can imitate healthy discs.
Artificial disc technology also allows for increased spinal mobility after surgery, and it places less stress on adjacent discs. In most patients, they have been proven to preserve motion at the operated segments; however, they have not been established to reduce the rate of symptomatic adjacent disc problems.
Common cervical disc degeneration symptoms are pain down one arm and neck pain. For patients with previous fusions, adjacent level diseases present with the new onset of symptoms similar to these.
WHEN AND HOW TO SEEK MEDICAL CARE
Consult with a spine surgeon if neck pain accompanied by arm pain is present. In order to see if symptoms can be alleviated without surgical intervention, rest and therapy are often prescribed.
The following criteria must be met for you to be considerate an artificial cervical disc candidate:
- In one or two cervical spine discs, which are herniating and compressing nerve roots and causing arm pain, disc degeneration must be present.
- Failed conservative treatment (e.g. physical therapy, neck bracing, or pain medication) without showing improvement
- Overall good health with no signs of osteoporosis, infection, osteomalacia, or arthritis
- No known metal allergies
If degeneration affects more than a single disc, any type of metabolic or hereditary/acquired bone disease, or segmental instability, the patient is not a candidate for an artificial cervical disc. This surgery is not recommended for patients who have undergone previous spinal fusion/surgical procedures at adjacent or the same cervical levels.
During surgery, while the patient is under general anesthesia, the surgeon makes a small incision in the front of the neck. The affected disc is removed and replaced through this incision. The average patient’s postoperative hospital stay is one to two days long. A similar artificial cervical disc has been used since 2004 in Europe, but little information is available on the number of surgeries performed to date.
- Need for additional surgery
- Allergic reaction to implant materials
- Bleeding; could possibly require a blood transfusion
- Blood vessel problems (other than bleeding)
- Progression or development of disease at other cervical levels
- Implants that break, bend, loosen, or move
- Incision problems
- Loss of motion at the treated cervical level
- Tingling or numbness in the extremities
- Pain or discomfort
- Side effects from anesthesia
- Nerve or spinal cord damage
- Leakage of spinal fluid
- Tears of the dura, which is a layer of tissue covering the spinal cord
It is routine for patients to have immediate postoperative x-rays. These confirm proper position of the device and alignment of the spine. Without the appearance of new symptoms, further imaging is often not required.
In a 2016 meta-analysis of artificial cervical disc versus standard cervical fusion, artificial disc patients with decreased evidence of adjacent level disease at four years of follow-up were shown. Beyond that timeframe, the value of artificial disc surgery over standard fusion is uncertain, and it is the subject of ongoing investigation.