Traditionally, spinal fusion has been the go-to surgery for addressing long-term neck pain or arm pain. Fortunately, as technology and surgical techniques continue to evolve, alternatives are emerging. Cervical total disc replacement surgery is an increasingly popular option for spine surgery, offering greater mobility, quicker recovery and a reduced risk for an additional spine surgery in the future.
The 2021 Position Statement From the International Society for the Advancement of Spine Surgery on Cervical and Lumbar Disc Replacement confirms that cervical disc replacement surgery is an effective alternative surgery that helps relieve back and neck pain while still preserving more motion than would be possible with spinal fusion.
Candidates for Cervical Disc Replacement
Cervical disc problems can then manifest in a variety of ways. One of the most common ways is a herniated disc, which results when the center of the disc (annulus) pushes through the exterior of the disc. It can subsequently press on the surrounding nerves and cause significant pain in the process. In these instances, cervical disc replacement can be a great option for resolving the issue. Once the damaged disc is removed and replaced with an artificial one, the patient is generally able to have their pain reduced and still retain motion in their spine.
Cervical total disc replacement is generally reserved for patients who have degenerative disc disease, a herniated or recurrent herniated disc, or a bulging disc. However, patients should first try non-surgical treatment such as physical therapy and epidural injections. If non-surgical treatments options do not result in pain relief, patients can then seek out an evaluation for cervical disc replacement surgery. It’s recommended to visit an experienced disc replacement surgeon for this evaluation.
For some spinal conditions, cervical disc replacement is not recommended. Instead, spinal fusion maybe the appropriate procedure. For example, it is not ideal for those who have scoliosis, significant facet joint disease, spinal fractures, spinal instability, or osteoporosis. It is also not recommended for patients with previous spinal surgery complications, autoimmune disorders or patients who are obese.
A comprehensive evaluation that will help determine the primary cause of your neck pain. A spine surgeon may recommend several tests, such as MRI scans, CT scans, X-rays, and bone density (DEXA), to ensure a disc replacement is the best treatment option for your needs. If you do not qualify for cervical disc replacement surgery, your surgeon will continue to help you find a treatment option that better suits your individual condition.
-
What is cervical total disc replacement?
Cervical total disc replacement, also known as total disc arthroplasty or, artificial disc replacement, is a type of surgery where a damaged disc in the cervical area of the neck is removed and replaced with an artificial one. The artificial disc is designed to mimic the form and function of the spine’s natural disc allowing for more natural motion.
-
What are the benefits of cervical disc replacement?
The benefits of cervical artificial disc replacement can include:
- Decreased pain and discomfort
- Reduced recovery time versus a spinal fusion surgery
- Preserved flexibility and range of motion
- Less stress on adjacent discs above and below the implant
- Less likelihood of future additional surgery
-
Where is cervical disc replacement performed?
Cervical disc replacement is performed through the front of the neck. Your surgeon will make a two-inch incision on the front or side of your neck at positions overlying the area of the neck that is involved. Cervical disc replacement can be performed at C4-5, C5-6, or C6-7. It cannot be performed at C1-C2, C2-C3, C3-C4, or thoracic levels.
-
What happens during cervical disc replacement surgery?
When you undergo cervical total disc replacement surgery, you’re placed under general anesthesia. The surgeon then makes a small two-inch incision on the side or front of your neck. The important structures of the neck are carefully moved to the side until the surgeon can see the front of the cervical spine. The affected disc is then removed, and the artificial disc is inserted in its place. The procedure takes approximately 1-2 hours.
-
Are cervical disc replacement implants FDA approved? Which implant will my doctor use?
Yes, there are several FDA-approved disc replacement devices available in the U.S. It’s important to discuss what device options are appropriate for you, as there are several factors a surgeon considers when determining which device to use. The physician will determine which implant is appropriate for you by examining your spinal anatomy, vertebrae size, disc height, and overall spinal stability.
-
How do I qualify for cervical disc replacement surgery?
Some of the common conditions that may make you a potential candidate for disc replacement surgery include:
- Neck pain with or without arm pain
- Conservative treatment without significant relief of pain
- Degenerative disc disease
- Herniated cervical discs
- Previous disc surgery with continued pain
- Qualifying for a spinal fusion
Your doctor will be able to discuss with you whether cervical total disc replacement surgery would be a solution for your specific condition.
-
I was told I need a spinal fusion. How do I know if I am a cervical disc replacement candidate?
If you are interested in finding out if you are a good candidate for this procedure, you should get a second opinion. It’s important to discuss artificial disc replacement surgery with a surgeon experienced in both fusion and ADR surgery to determine if it is an appropriate treatment option for you.
-
Are there any conditions that cervical disc replacement won’t work for?
The causes behind neck pain can be quite complex and interconnected across the disc and surrounding spine. For example, patients with conditions such as scoliosis, ankylosing spondylitis, spinal fractures or significant facet joint disease would not qualify for disc replacement, and might be better served with fusion or other type of treatment. It is also not recommended for patients with previous spinal surgery complications, autoimmune disorders, or patients who are morbidly obese.
-
Can I have a cervical disc replacement if I am allergic to metals such as nickel
Yes, there is now a cervical disc replacement that is FDA approved for patients who have a metal allergy to nickel.
-
What is the recovery process like after cervical disc replacement?
Patients are typically up and walking a few hours after surgery and go home the next morning after surgery. Cervical disc replacement patients will wear a soft collar for comfort for a short period of time to provide additional support, if necessary. Typically, you should be able to return to work within 2-4 weeks and resume most recreational activities after 2-3 months.
-
Is cervical disc replacement covered by insurance?
Most insurance plans cover cervical disc replacement, except Medicare and Medicaid plans. You should contact your insurance company to learn more about your specific plan coverage.
About Cervical Total Disc Replacement Surgery in Texas at The Center for Disc Replacement
The Center for Disc Replacement is a specialty program located in Plano, Texas at Texas Health Center for Diagnostics and Surgery. Spine surgeons on the hospital’s medical staff are pioneers of artificial disc replacement surgery, having performed thousands of artificial disc replacement procedures. The spine surgeons at the Center for Disc Replacement participate in and are committed to clinical research that allows early access to the latest arthroplasty technologies and have authored numerous publications about disc replacement technology.
If you’re considering cervical total disc replacement surgery and are interested in finding out if you are a candidate for this procedure, contact our program director today who can talk with you about the process, answer any questions you may have, and discuss whether this type of surgery could be an option for you.
Not local to Texas? Many of our patients live outside the Dallas-Fort Worth area, even in other states, and travel to Plano for their disc replacement surgery. We are happy to help coordinate this process with you.
To make an appointment of for additional information, contact us at 844-544-9501 or TheCenterforDiscReplacement@thcds.com.