Who is a Candidate for Cervical Disc Replacement?
Cervical disc replacement is often recommended by top spinal surgeons to manage nerve pain caused by a damaged disk in the neck, otherwise known as the cervical spine. This procedure involves removal of a damaged or degenerated cervical disc and replacing it with an artificial disc device that has been shown to be safe to implant in the body. After time spent in physical therapy, pain medications, and spinal injection procedures, patients who have found no relief generally are interested in a more direct solution. At that point, there are multiple effective surgical options for relieving nerve pain due to a worn-out or damaged cervical disk in the neck that can be considered, though not all options may be the most effective treatment for a specific patient.
If cervical spinal surgery is being considered, a spinal surgeon will explain the different approaches to manage cervical disc problems. One such option is performing a procedure on the back of the neck, called a posterior discectomy or lamino-foraminotomy. Options from the front of the neck include an anterior discectomy and fusion, in which the disc is fully removed and the bones joined together using bone and/or a specialized implant to allow bone to heal across, and a cervical disc replacement. While a cervical disc replacement procedure also includes the full removal of the damaged disc, instead of promoting the two surrounding bones to heal together, it instead replaces the disc with an ‘artificial disc’ to allow continued motion.
Since many patients are interested in potentially being able to preserve some motion across a damaged disc, the question remains: are you a good candidate for cervical disc replacement?
Here are some general guidelines for who is considered a good candidate for cervical disc replacement:
- Adults between the ages of 18 and 60 with symptomatic cervical disc disease who have failed to experience improvement after six months of non-operative care (physical therapy, pain medications, and possibly injections).
- Patients who are healthy and otherwise a candidate for cervical spine surgery such as a cervical spine fusion.
- Patients who have only one or two discs damaged enough to cause compression of a nerve (If there are two discs requiring treatment, however, there is currently only one type of disc replacement allowed to be used at two different levels, and your spine surgeon may or may not be used to using this particular device)
Who is not an ideal candidate for cervical disc replacement:
- Patients who have abnormal motion or instability at the affected region of the neck; this can be evaluated on X-rays in which you flex your neck forward and backward
- Patients who have advanced degenerative/arthritic changes, known as spondylosis, affecting the small joints in the back of the spine at the affected level
- Patients who have significant osteoporosis, as the device may wear into weakened bones
- Patients who have an infection in the affected region of the spinePatients who are pregnant are not candidates during the period of pregnancy, though they could be candidates later after they have delivered
- Patients who are morbidly obese
- Patients with specific allergies (especially certain metal allergies) are not candidates.
- The procedure should not be used on children or adolescents
Discuss your medical history and current conditions with your spine surgeon with complete accuracy, so that your surgeon can assess if you are among the patients who do fit the ideal candidate description and to make sure that your spinal surgery results in the best outcome for you.