When Undergoing Cervical Disc Replacement Surgery
The word “surgery” is always frightening to patients. However, whenever a doctor indicates surgery is necessary, it means that surgical treatment is truly required. It would be better to change the time of worry into preparation by studying information about the surgery, its benefits, and the precautions before and after surgery, just as we are getting to know “cervical disc replacement surgery”.
The most common cause among patients with chronic neck and back pain is a herniated disc pressing on the nerves. This is due to changes in the intervertebral discs, which may result from aging, injury to the discs themselves, or other contributing factors, including lifestyle behaviors such as prolonged sitting and lack of exercise. These causes have led to an increase in the statistics of chronic neck and back pain across almost all occupations and age groups.
Treatment for Patients with Degenerative Cervical Discs or Herniated Discs Pressing on Nerves
Through surgery, the surgeon will remove the damaged intervertebral disc and replace it with a material to substitute the removed disc, aiming to restore the normal height of the disc space. There are various types of materials used for replacement, each with different advantages and disadvantages. Currently, the materials used for disc replacement are as follows:
- Bone, mostly using iliac crest bone from the waist area
- Artificial bone
- Artificial disc
Materials in items (1) bone and (2) artificial bone cause the vertebrae to fuse together, stopping the movement of the spinal joints. In cases with degeneration of various joints, this can reduce symptoms caused by abnormal joints but may increase the workload on adjacent joints.
For (3) artificial discs, they are used to replace the intervertebral disc and function as the removed disc did, or as close to the original as possible, especially in spinal joint movements such as bending, extending, or rotating. This helps reduce the workload on adjacent joints, slowing down their degeneration, and is used in patients with herniated discs pressing on nerves or degenerative discs.
Symptoms of Patients with Herniated Discs Pressing on Nerves or Degenerative Discs Depend on the Severity of the Condition as Follows:
- Initial symptoms: If there is only disc degeneration, patients will have chronic neck pain, severe pain when bending or extending the head, often radiating to the occiput or both shoulders.
- Increased symptoms with nerve compression: Symptoms of nerve involvement such as radiating pain down one or both arms, numbness, or weakness in the arms.
- Severe cases with spinal cord compression can cause weakness in the arms and legs or even paralysis.
Treatment
In cases with only early-stage pain, doctors will recommend treatment with medication, behavioral modification, and physical therapy. If ineffective, surgery will be considered. However, if there are neurological abnormalities such as numbness or weakness, surgery may be recommended immediately because delaying treatment can cause permanent nerve damage. Surgery involves removing the disc portion compressing the nerve and replacing it with an artificial disc.
Limitations of Using Artificial Discs
The spinal joints in the treated area must still be in good condition because the artificial disc replaces the damaged disc. After surgery, the replaced disc area will have improved movement. If the patient has joint problems, it may cause increased pain.
Advantages of Artificial Discs
- Maintains normal neck movement
- Reduces the risk of accelerated degeneration of adjacent joints
- Reduces pain as there is no need to harvest bone from the waist
- Allows faster neck movement, enabling quicker return to work
Disadvantages of Artificial Discs
- Limited indications for some patients, such as elderly patients or those with posterior joint degeneration
- Expensive materials
Artificial Disc Replacement Surgery
The surgery is performed from the front, with an incision on the side of the neck about 2-3 cm in size. The degenerated disc and any bone spurs compressing the nerves are removed entirely using a surgical microscope. The artificial disc is then inserted, and fluoroscopy is used to check the position for accuracy. Patients can stand and walk immediately after surgery, with a hospital stay of about 3-4 days.
However, every time artificial disc replacement surgery is performed, doctors always inform patients and their families of the facts. Although the surgery is currently very safe due to the use of surgical microscopes, risks may still occur, such as infection, blood loss during surgery, nerve or spinal cord injury. Although these risks are serious, they are very rare. There are also risks related to the implanted device, such as deterioration or malfunction of the artificial joint. Although uncommon, these can happen. Therefore, doctors must provide comprehensive information to patients before treatment.
Phyathai 3 Hospital has a team of specialists and modern equipment ready to provide services so patients can return to normal life.
Dr. Teerachai Phanitpong
Neurosurgeon and Spine Surgeon
Phyathai 3 Hospital
