The disc is soft material placed between two vertebrae, which serves as a cushion and permits mobility of the neck.
The patient has arm and neck pain. The first line of treatment is rest, pain relief medication, physiotherapy and a soft cervical collar. This simple treatment is effective in the vast majority of cases. Surgery for cervical disc prolapse is done in a setting of neck and arm pain (called radiculopathy) which has proved unresponsive to pain relief medicine, and physiotherapy, or if the patient has loss of function or weakness or in extreme cases paralysis of the muscles of the arm.
The surgical options are to remove the part of the disc that is pressing on the nerve root, and replace it with a piece of bone that is harvested from the pelvis and which is then secured with plate and screws.
This technique is referred to as fusion. The second surgical option is to remove the offending disc and use an artificial disc, instead of graft, plate and screws. It must be stated that both techniques are highly effective as a cure for neck and arm pain. The focus of this article is cervical disc replacement.
When all the non-surgical procedures including physical therapy, medications and injections fail to relieve pain, orthopaedics doctors suggest disc replacement surgery. The affected disc is replaced with an artificial one to replicate the functions of a normal disc. The artificial disc allows normal motion and carries the load like the real one. The procedure takes anywhere from 1 to 2 hours and is performed under general anaesthesia. After the surgery, the patients have regular follow-ups with the surgeon/doctor.
Certain medical conditions such as infection, vertebral body fracture, spinal tumor, pregnancy, allergy to the materials in the device (prosthesis), osteoporosis can prevent one from receiving a disc replacement surgery.
The right candidates for a disc replacement surgery are those who qualify the following parameters:
No previous history of disc surgery
Is in good health
Is not suffering from osteoporosis
No history of spinal infection or arthritis
Has had at least one month of non-surgical treatment to improve the condition, but is still symptomatic
Nerves in the spinal canal are compressed as seen on the MRI scan
Do not have any type of spine deformity
Return to daily functions
Relief from pain
Patients who have undergone a disc replacement surgery usually require staying in the hospital for a maximum of one or two days. Any extra pain or unexpected difficulty may require an extra day or two in the hospital. With the support of a collar, the patients are able to walk the following day.
During the recovery process, doctors also advise a few gentle exercises. To ensure the disc is in place, the doctor calls the patient for a follow up within a month of the surgery and performs an X-ray to check the condition.
A variety of complications may occur after a disc replacement surgery. These include breaking and bending of the implant, nerve injury, allergic reaction to the implant material, reaction to anaesthesia, blood clot, tissue swelling and more. Thus follow up with the surgical team is necessary.
IMPORTANT NOTE: THIS IS A BRIEF WRITE UP OF A TREATMENT FOR CERVICAL DISC PROLAPSE AND IS FOR THE PURPOSE OF DISSEMINATING KNOWLEDGE. IT IS NOT MEANT TO BE MEDICAL ADVICE. DISCUSSION WITH THE TREATING SURGICAL TEAM IS A MUST TO GAIN A THOROUGH UNDERSTANDING OF THE SURGICAL PROCEDURE, ITS INDICATIONS AND OUTCOMES.