Artificial disc replacement is one of the two most common and effective surgeries for treating neck pain, as well as pain or numbness in your neck, arms, or hands. Artificial disc replacement (ADR) is often used instead of anterior cervical disc replacement and fusion (ACDF). While artificial disc replacement is a good surgery for neck pain, you should understand the differences between the two spine surgeries, and which one is most appropriate for your condition. I hope with this blog post I can help you get a better understanding of cervical artificial disc replacement.
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Understanding Your Neck Pain
In today’s blog post, I’ll talk about artificial disc replacement vs. ACDF to treat conditions of the cervical spine. This is the second post of a four-blog series. The first post discusses the most common types of neck pain.
Upcoming blogs are:
- Three signs disc replacement might be right for you
- Recovering from neck surgery
If you live in the Denver area and are considering neck pain surgery, you will first need to get a thorough examination by a Denver spine surgeon and a definitive diagnosis. Many people—in fact, up to 2 in every 10 Americans—suffer from some form of neck pain each year. Neck pain that requires treatment is often accompanied by pain, numbness, or a tingling sensation in your shoulders, arms, and/or hands. Most neck pain, however, is temporary, meaning it will subside with minor adjustments to your lifestyle or conservative treatment such as physical therapy, massage, or over-the-counter pain relievers.
Recent advancements in surgical technology have improved artificial disc replacement (ADR) and have made it a good option to spinal fusion in some cases. Both have great outcomes for patients, but ADR allows for continued mobility of the neck or spine area. Keep reading to find out more about the benefits of this procedure.
Reasons Your Doctor May Recommend Artificial Disc Replacement Surgery for Your Neck
First, it’s important to understand that each person’s situation is unique. To determine if your neck pain warrants neck surgery, your doctor will perform a history and physical to learn about your situation. Tell them about your symptoms, how they impact your daily life, and when they first started.
They may order X-rays or magnetic resonance imaging (MRI) to look at your spine. The spine contains bones, called vertebrae, stacked on top of each other. Between each vertebra, there’s a gel-filled spinal disc that acts as a cushion.
If these tests show damage or compression of the disc, this may indicate degenerative disc disease. If this is present in only one or two discs in your neck, your Denver neurosurgeon or spine surgeon may recommend ADR rather than the more traditional anterior cervical discectomy and fusion (ACDF).
While every patient is different, there are some general guidelines of who is a good candidate for ADR. My colleague, Dr. Jason McGowan, goes into more detail about the qualifications for ADR, which also can be called cervical disc arthroplasty (CDA) in his blog:
- Have ongoing pain in their neck and arms
- Feel numbness, weakness, or tingling in their hands and arms
- At least 22 years old and the evidence that the bones have stopped growing
- Lack of improvement after six weeks of medications and physical therapy
ADR isn’t advised for patients with severe disc degeneration, severe osteoarthritis, facet joint arthritis, or cervical spine instability. Other exclusions include active infections and previous fusion surgery in the same area. If your degenerative disc disease involves more than two discs in the neck, you also are not a candidate due to FDA restrictions.
What Is a Cervical Artificial Disc Replacement?
The purpose of an ADR is to remove a damaged or worn spinal disc. It’s then replaced with an artificial one to eliminate the pain and restore your function. This procedure is often preferred over a fusion because you can retain movement in that area.
Today, there are several different designs, materials, and techniques for ADRs. Many have two metal plates that attach to the vertebrae above and below the space. The artificial disc sits between these plates.
Common materials include cobalt-chrome, polyethylene, stainless steel, porcelain, and titanium. Surgeons often coat the endplate surfaces with hydroxyapatite, calcium phosphate, or porous titanium.
The endplate is where the disc and the vertebrae meet. These coatings help encourage bony ingrowth to solidify the attachment.
What Happens During Disc Replacement Surgery?
Before the surgery begins, you will have an intravenous line (IV) placed in your arm. Through the IV, you will receive fluids and medications to help you relax and feel sleepy. The anesthesia provider will give you general anesthesia (so you’re asleep).
After you’re asleep, a tube is placed down your throat. This protects your airway and lets you receive oxygen as needed. The providers watch your heart rate, oxygen level, and blood pressure at all times.
The surgical staff cleans your neck with a special solution that kills germs. Next, the spine surgeon makes a small one- to two-inch cut (incision) on the front or side of your neck. They move the parts of the neck to the side so they can see the vertebrae and disc.
First, they remove the damaged cervical disc. Then the surgeon places the artificial disc in the empty space. Last, your surgeon will close the incision with stitches.
The wound is then bandaged and you’re taken to the recovery room where you’ll wake up.
What is Artificial Disc Replacement Recovery Like?
It’s normal to feel pain after this procedure. You will receive pain medicine while you’re still in the recovery area.
Ask your doctor if you will be staying in the hospital. With artificial disc replacement surgery, most patients are discharged from the hospital within 24 hours.
The doctor may keep the IV in for a while to give you fluids and medication. You’ll be able to start eating and drinking as usual once you’re fully awake.
It’s important that you tell the nurse as soon as you start feeling pain. You’ll get better relief from the medicine when it’s taken before the pain is severe. The staff will help you get out of bed and start moving around when you’re able.
When you’re discharged from the hospital you will get instructions for home care including how much activity you can do and when you can take a shower. We will schedule an appointment for you to return to make sure everything is healing well. After a few weeks, you may start physical therapy. Most patients can return to full activities four to six weeks after surgery.
Call your surgeon immediately if have any of the following problems:
- Fever
- Headache
- Drainage, redness, swelling, or bleeding from the incision
- Weakness or numbness
- Unable to relieve the pain after taking the prescribed medication
- Trouble swallowing
- Trouble breathing
- Changes in your voice such as hoarseness
What are the Benefits of Cervical Artificial Disc Replacement Surgery?
A 2016 study published in PLOS ONE 10[1] found that artificial disc replacement resulted in better function outcomes, less need for additional surgery, and fewer complications than fusion. Other potential benefits[2] of artificial disc replacement over traditional fusion surgery include:
- Maintains full range of neck motion[3]
- Reduces the likelihood of degeneration in adjacent segments of the cervical spine[4]
- Eliminates the potential complications associated with bone graft used in fusion surgery[5]
- Shorter recovery time: most patients are able to resume normal activities within a few weeks
- Most patients can resume full activity, including vigorous activities, such as jogging, as soon as three months
Are You Looking for A Spine Doctor?
My colleagues and I at Neurosurgery One strive to offer the best care. We treat each person as an individual with a customized plan of care. We offer the most advanced procedures and technology available. This includes many options for minimally invasive brain and spine surgery. These procedures reduce recovery time, and you’ll have less post-surgical pain.
Contact us today to schedule a virtual or in-person appointment.
[1] https://pubmed.ncbi.nlm.nih.gov/25310394/
[2]https://www.clinicalpainadvisor.com/back-spine-pain/artificial-disc-replacement-in-2-level-cervical-disease-long-term-outcomes/
[3] https://pubmed.ncbi.nlm.nih.gov/25310394/
[4] https://pubmed.ncbi.nlm.nih.gov/25310394/
[5]https://www.spine-health.com/treatment/artificial-disc-replacement/artificial-disc-vs-anterior-cervical-discectomy-and-fusion
