Cervical Disc Replacement from a Spine Surgeon in New Jersey

Cervical disc replacement is a surgical procedure that involves removal of a damaged or degenerated cervical disc and replacing it with an artificial disc device. Cervical discs are the cushions or shock absorbers between the bones (vertebra) of the neck (cervical spine). Discs that become damaged either through trauma or degeneration can be a source of pain. If part of a disc displaces out of its normal position it can cause pressure either on the central spinal cord or on the individual nerve roots that exit from the spinal canal at each vertebral level. Over time, the body’s reaction to a disrupted disc is the formation of bone spurs called osteophytes that can also cause pressure on the spinal cord or nerve roots. Pressure on the spinal nerves from a disc or bone spur can cause neurologic symptoms which may include numbness, weakness, or pain that radiates from the neck into one or both arms. Disc disruption and degeneration can be a source of neck pain as well.

The standard initial treatment for symptomatic cervical disc disease typically involves physical therapy, medications, and occasionally spinal injection procedures that involve injecting anti-inflammatory medications directly around the spinal nerves. If the symptoms persist and are very bothersome for more than 6-12 weeks, surgical treatment can be considered. While a small portion of patients with a disc herniation in a specific location can be managed with a procedure performed on the back of the neck called a “posterior discectomy” or “lamino-foraminotomy,” the most common and traditional operation for symptomatic cervical disc disease involves an anterior cervical discectomy and fusion surgery, sometimes called an “ACDF”.

With the anterior cervical discectomy and fusion technique, an incision is made in the front of the neck following which the surgeon removes the damaged and protruding disc and associated bone spurs in order to relieve any pressure on the spinal cord and nerve roots. After the disc is removed, the gap that has been created between the two bones is then typically filled with a piece of bone graft (obtained from a cadaver or from the patient’s pelvis) or with a synthetic (titanium or medical grade plastic) cage device. Once the pressure on the nerves has been relieved, the goal of the procedure is to cause the two bones to grow together (called a fusion), resulting in a complete loss of motion at the surgical level. In the anterior cervical discectomy and fusion procedure, a plate with screws is frequently applied to the front of the spine to provide initial stability, which assists in achieving a solid fusion. Following the fusion, patients are often immobilized for up to six weeks in a specialized neck brace called a cervical collar. X-rays are also obtained at different time points after the surgery to determine whether the fusion has healed.

More recently, cervical disc replacement, also known as total disc arthroplasty, has become an FDA-approved option for surgically treating symptomatic cervical disc disease. This procedure is similar to the anterior cervical discectomy and fusion, except that the gap that is created by removing the disc from between the two vertebrae is filled with a disc replacement device. A disc replacement device is typically composed of two metallic surfaces, one of which is attached to the upper vertebra and the other to the lower vertebra at the affected disc level. These metal implants can then slide on each other directly or slide on medical grade plastic sandwiched between. The device allows for motion between the two vertebrae to be maintained and avoids the need for a fusion. The disc replacement device can be secured in place with screws or it may have an anchor that holds the implant to the bones with a tight fit (Figures 1 and 2).

Cervical Disc Replacement Candidate Information and Risks ››

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