Cervical Disc Replacement
The cervical intervertebral disc absorbs a large compressive load whilst providing an impressive range of movement and so when issues start to arise within the discs it can have a detrimental impact on your daily life.
A prolapsed ('slipped') disc in the neck or a very degenerate disc may cause significant neck & arm pain. In more serious cases, weakness of the arms & hands may be felt and even the spinal cord itself may be affected.
In those cases where surgery is required to remove the pressure from the nerve(s) or spinal cord, the surgery often calls for removal of the damaged disc & the other tissue causing the pressure. This is typically done through the front of the neck (so called anterior surgery). Mr Cass uses a small incision, usually about 1- 1 1/2 inch long, in your neck. He will then move all the structures and soft tissue to one side so he can access the spine. The damaged disc will be removed along with any disc fragments or boney spurs (osteophytes) that may be compressing the spinal cord or nerves.
Following this, the neck needs destabilising by filling the space where the disc has been removed from.
A cervical disc replacement is sometimes used for cervical prolapses that are causing significant neck and/or arm pain, that have not improved with non surgical treatment. Whether Mr Cass recommends this surgery for you will depend on a variety of factors, including the type of nerve or cord compression and the overall condition of your spine.
The advantage of a cervical disc replacement is that it aims to maintain the normal movement in the segment of spine from which the damaged or worn disc is being removed. This is the opposite of the older procedure of fusion, where the spine is stabilised by inducing the two vertebrae on each side of the disc in question to fuse or 'weld' together into a single solid block. The advantages of a disc replacement therefore are maintenance of greater neck movement after surgery, and importantly a decrease in the transfer of greater forces to the adjacent discs. This transfer to the next-door discs is now recognised as a risk in these discs also degenerating - the so called 'domino effect'.
It is important to understand that replacement surgery is not suitable for everyone. Your individual case will be carefully assessed by Mr Cass and the solution which is best for you offered.
The space is then cleaned before the artificial one will be inserted into its space, which is all done under X-Ray guidance. The muscles and skin will then be sutured together.
The majority of Mr Cass’s patients will go home the following day, after being reviewed on the ward by Mr Cass and the physiotherapist.
This procedure has an overall 80-90% success rate in relieving arm symptoms, however this may not be felt immediately and can take several weeks for the nerve to fully recover.