Am I suitable for a cervical disc replacement?

In one of our latest articles here below, distinguished Ipswich-based consultant spinal surgeon, Mr Robert Lovell, explains in expert detail what a cervical disc replacement treats, and details how the procedure is generally performed.

What does a cervical disc replacement treat? When is it recommended?

A cervical disc replacement is one option when undertaking surgery in the cervical spine to relieve pressure on nerves from discs or overgrown joints. In these kinds of operations, the disc is removed, which leaves a gap.

Either a replacement disc or artificial bone block (fusion) is used to fill this gap. Disc replacements are useful in relation to maintaining a small amount of movement at the operated level to help protect the discs above or below the operated one from wearing out.

Who qualifies for a cervical disc replacement?

Disc replacements will be more suitable in younger patients with less wear in the neck. Typically, patients will undergo surgery for a slipped disc giving rise to arm pain rather than those with overgrown joints pushing on nerves or the spinal cord.

In order to be suitable for the operation, the patient’s neck must be a normal, standard shape with some movement at the operated level. Older, more arthritic necks, as well as those with other problems such as osteoporosis, are not suitable, unfortunately.

How is a cervical disc replacement performed, and what can patients do to prepare?

It is performed under general anaesthetic through a small incision that is made in the front of the neck. It will usually need an overnight stay. Patients don’t need a collar or any major restrictions afterwards.

There are no specific preparations other than normal pre-operative assessment for spinal surgery. The most important preparation is to make sure that the patient knows what they are having done, why they are having surgery, and what to expect both pre and post-operatively. The operating surgeon will go through this in detail as part of informed consent.

What are the risks and complications of a cervical disc replacement?

The risks specific to a cervical disc replacement are numerous. They include the following:

• a small risk of swallowing and voice problems
• damage to the spinal cord or nerves
• problems with the levels above or below

Detailed information can be found on the British Association of Spinal Surgeons website where patients can download information leaflets for specific spinal operations.

How should patients take care of their necks following surgery?

The most important thing is to keep the neck moving so that it doesn’t become stiff and the muscles don’t become tight. Post-operative physiotherapy is not always required, but may be useful for some patients.

Is a cervical disc replacement long-lasting?

Yes, indeed it is. A whole host of studies have shown positive long-term results, with outcomes as good as or, in some cases, even better than fusion. As with most surgical procedures, if the initial decision to carry out a replacement was not the right one, then the long-term outcome will not be as favourable. When replacement (arthroplasty) is done well for the correct reasons, it is a very good, reliable, and long-lasting operation.

When would further surgery be considered?

Further surgery may be considered if similar problems occur elsewhere in the neck. Thankfully, this is uncommon. The decision as to whether to carry out surgery anteriorly or posteriorly is dependent on many factors.

Book an appointment with Mr Robert Lovell today via his Top Doctors profile if you are considering undergoing a cervical disc replacement in the near future.