Monday, May 27, 2013

Cervical Disc Replacement: Risks and Benefits


People who have tried and failed conventional non-surgical treatments such as exercise, anti-inflammatory medication, chiropractic, physical therapy, etc. to relieve their neck pain can benefit from cervical disc replacement surgery.

Discs in the entire spinal column, which are 23 in total, 6 of which are cervical discs, act as cushions or shock absorbers between the bones (vertebrae) of the spine. These discs may deteriorate due to cervical disc diseases like failed cervical fusion and degenerative disorders in the cervical, which can cause neck pain, arm pain, arm weakness or numbness.

When non-operative methods like physical therapy and drugs fail to provide back or neck pain relief, patients suffering from neck (cervical) disc disease often turn to replacement surgery as a last resort.

The Surgical Overview
Cervical disc replacement involves inserting an artificial disc in the space between two vertebrae (spinal bones) to replace the painful, diseased or damaged disc while keeping your normal neck motion. The artificial disc mimics the function of a natural spinal disc.

In the surgery, the damaged disc is completely removed including any impinging disc fragments or osteophytes (bone spurs) and the disc space is returned to the height it was prior to disease.

The cervical disc(s) may degenerate or damage as a result of direct trauma, arthritis, gradual changes or an unknown cause, leading to neck pain from inflammation or muscle spasm and severe pain, weakness and numbness in the arms from pressure on the cervical nerve roots.

Surgical replacement of a disc with an artificial device is a relatively new procedure. The first replacement surgery for the low back (lumbar spine) was approved by America's Food and Drug Administration in June 2004 for use in the country.

As a matter of fact, disc replacement surgery is not a procedure suitable for everyone. Patients with brittle bones from osteoporosis or other significant diseases may not be good candidates for this type of surgery. Problems like infection or severe degeneration of the spinal joints may also keep a patient from having this operation.

Potential Risks and Complications
As with any spine surgery, cervical disc replacement surgery is not without risk. A variety of complications with an artificial disc may occur, either alone or in combination. Although rare, but these complications can be severe.

The potential surgical complications may include:

Wound infection
Allergic reaction to the anesthesia
Spinal fluid leak
Blood loss
Nerve injury or paralysis
Need for further surgery
Injury to the spine's nerve tissue and veins, and arteries near the spine
The injured spinal cord or the nerves can result in impairment or complete paralysis of all four limbs.
Paralysis of certain muscles in the arms or legs may also occur following the injury to the nerves.
Inability to resume routine activities, including sexual activity, following the surgery.

Benefits

Normal neck motion can be maintained
The artificial disc absorbs some of the daily stresses of the neck.
The procedure eliminates the need for a complex and painful bone graft, which can be difficult to heal and has a risk of an infection transmission from grafting material.
Following cervical disc replacement, the adjacent spinal discs don't have to bear the extra stress (versus a fusion procedure).
The artificial disc surgery patients recover more quickly than the spinal fusion patients.
The surgery has lesser chances of requiring a revision surgical procedure.
The chances of device failures (breakages) are significantly less.
Lesser number of cervical disc replacement patients need a hard collar surgery.
Since the healing time from a cervical disc replacement is quicker, the patient is able to return to almost every type of activities faster.

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