Cervical Disc Replacement

Cervical disc replacement can be an excellent alternative to fusion in the neck.

Preserving movement with a disc replacement reduces the strain on other neck levels which is seen following a traditional fusion.

I have had specialist training to perform disc replacement which may not be available elsewhere.

Uses

Like fusion in the neck the most common reason for having a disc replacement is freeing a trapped nerve, usually caused by a disc herniation and/or bony spur.

Procedure

Disc replacement surgery is always performed through the front (anterior) of the neck.

I make a small horizontal skin incision (about 3cm) and gently dissect to reach the spine without damaging any muscles or important structures.

The whole disc must be removed to reach the trapped nerve.

The disc herniation or bony spur is then nibbled away freeing the nerve root.

Up to this point the surgery is almost identical to performing a cervical fusion.

Now we have a choice – fusion or disc replacement – which we will have discussed before surgery.

I carefully prepare the disc space to accept the correct sized disc replacement. (Occasionally the anatomy dictates that a traditional fusion is best)

I use a disc replacement with a long tract record of success and follow-up. Usually the artificial disc is made of a combination of a metal alloy with a polyethylene bearing surface.

Live imaging is used to help position the disc perfectly.

The skin is then closed over a drain which is there to collect any blood.

The whole procedure takes just over one hour.

Benefits

Cervical disc replacement has an excellent chance of being successful and recovery is usually rapid.

You have at least an 80% chance that your arm pain will be better. Neck pain like back pain may be less predictable following surgery.

There is a 10-15% that you are improved but still not completely better. This may reflect the nerve remaining bruised from being compressed.

Risks

Surgery on the neck sounds alarming however it is generally quite safe with a low risk of complications.

Overall there is a 2-3% chance of having a complication which includes a nerve injury, spinal fluid leak, infection, implant migration, hoarseness, swallowing problems, bleeding. Devastating spinal cord injuries are thankfully exceptionally rare.

About 5% of individuals (one in twenty) may have ongoing pain despite the nerve being successfully decompressed.

Recovery

In my experience patients recover very quickly from anterior cervical surgery and there is no significant difference in short term recovery between having either a fusion or disc replacement.

You will wake up with a small drain in the neck which prevents any blood collecting. We remove this simply within 24 hours.

You will be up and about within a few hours of the procedure and home within a day without the need for a collar.

I use a dissolvable suture which all patients prefer.

Simple painkillers may be helpful over the first week or so but usually arm pain is very quickly better. Pins and needles and numbness may take longer to settle as the nerve recovers.

Swallowing may feel a bit ‘sticky’ due to bruising for a week or so before settling.

You can build up your walking and aerobic exercise each day.

You can return to non-manual work within a few weeks or when you feel ready.

I will see you back in clinic six weeks after your operation and then 3 months later.

You can return to non-contact competitive sport from 3 months, and one year for contact sports such as rugby.

Further Information

I am here to support you before and after your operation and you can talk to me or the team at any time.

I recommend you read the comments from my patients of their experience under my care.