Cervical Disc Replacement Surgery for Severely Damaged Cervical Spines

Cervical disc replacement surgery

What is a cervical disc? How and why is cervical disc replacement surgery performed?

Cervical disc replacement surgery involves removing a damaged or diseased bone in the neck (cervical) area of the spine and replacing it with one made of plastic or other surgical materials. It is easier to understand cervical disc replacement surgery if you have a basic understanding of your spine and the structures of parts that hold it together. You may have seen a model of your discs and backbones (vertebrae) in your doctor’s office when the possibility of cervical disc replacement surgery was discussed.

Your spine is made up of backbones or vertebrae, all stacked up in a column. The cervical spine consists of the vertebrae in your neck area. There are seven of these backbones. Your cervical discs are cushion-like round structures that are found between the vertebrae in the neck. They function like shock absorbers. They also allow your neck to move freely and prevent the backbones from grinding against each other.

Your vertebrae, including the backbones in your neck or your cervical vertebrae, form a bony passageway. The spinal cord runs through this protective tunnel. Attached to the spinal cord are nerves that exit the spinal column through spaces between the vertebrae. The spinal nerves in the cervical area supply the upper body with movement and feeling or sensation.

When cervical disk replacement surgery is performed, a damaged or diseased cervical disc is taken out and replaced with an artificial one.

Using an artificial disk to replace a worn or damaged cervical disc is a recently FDA-approved treatment. Traditional surgery for cervical disc disorders involved fusing the bones of the spine together to fill the space where the damage disc was removed. Cervical disk replacement surgery can allow for more mobility and may have less risk for future complications than the traditional surgical procedure.

Reasons for cervical disc replacement surgery

Cervical disc replacement surgery is recommended when the spinal cord or spinal nerves are pinched or compressed because of the loss of space between the vertebrae. Compression of the spinal cord or its nerves causes symptoms like severe pain, tingling, and/or numbness along the path of the nerve, or muscle weakness in the area of the body served by the nerve. When non-surgical treatments are not effective in treating the symptoms, cervical disc replacement surgery might be recommended.

The space between the vertebrae in the cervical spine usually begins to shrink due to disc degeneration, or wear and tear damage that happens over time and with aging. The discs start to collapse due to age and may bulge. Disc degeneration is common in most people by the time they are 60 years old, but not everyone develops painful symptoms.

Symptoms of cervical disc degeneration that may eventually lead to the need for cervical disc replacement surgery include:

  • Severe neck pain and stiffness
  • Headaches
  • Neck or upper back pain radiating into one or both shoulders or arms
  • Muscle weakness in the arms, hands, shoulders, or legs
  • Tingling or sensations like "pins and needles" and/or numbness in your arms and hands

Risks associated with cervical disc replacement surgery

Cervical disc replacement surgery is considered a safe operation, but no surgical procedure is without some risk of complications. Prior to cervical disc replacement surgery, patients are given a full explanation of the procedure and the possible risks and are required to sign a form consenting to surgery.  

Since doctors have not been performing cervical disc replacement surgery for many years, little information is available about the long-term risks. Your surgeon is likely your best source of information regarding the particular risks and the benefits of cervical disc replacement surgery versus traditional spinal surgery.

Some of the possible complications of any cervical spine surgery, traditional or cervical disc replacement surgery, include:

  • Reactions to anesthesia
  • Infection
  • Bleeding
  • Injury to the spinal nerves
  • Leakage of spinal fluid
  • Stroke
  • Voice change
  • Breathing problems
  • Swallowing difficulties
  • Continued symptoms
  • Need for repeated surgeries

Depending on an individual’s unique medical condition, there might be other possible risks associated with cervical disc replacement surgery. Ask your doctor about any concerns you have prior to surgery.

Preparation for cervical disc replacement surgery

Before you are scheduled for cervical disc replacement surgery:

  • Make sure your surgeon is aware of all the medications you are currently taking. This includes prescription as well as any over-the-counter medications and herbs or natural preparations or supplements. If you take blood thinner or aspirin, you will be asked to stop taking these prior to surgery.
  • Tell your doctor if you have ever had a reaction to any type of anesthesia. Also inform your surgeon if anyone in your family has had a problem with anesthesia.
  • If you are a smoker or use tobacco products, try to stop. Tobacco products increase the risk of complications related to cervical disc replacement surgery.  
  • Make sure you understand when to fast. You will be given written instructions on how long prior to cervical disc replacement you need to stop drinking and eating. Most patients are NPO (nothing by mouth) after midnight on the night prior to surgery.
  • Ask your doctor if your usual medications should be taken on the morning of surgery with a small swallow of water.

What happens during cervical disc replacement surgery?

An intravenous (IV) line will be started just before cervical disc replacement surgery starts. Medications will be given through this line to make you feel relaxed, and fluids can be given through the IV. Cervical disc replacement is usually done while you are asleep (under general anesthesia. Once surgery begins, it may take a few hours to complete.

An incision is made in the front or on the side of the neck. The incision is about one to two inches in length. After the damaged or diseased is removed and the artificial disc is inserted, the incision is closed and a small bandage is applied. A collar or brace is sometimes placed on the neck to help support the spine following cervical disc replacement surgery. Patients wake up after they are in the surgical recovery area.

After cervical disc replacement surgery

Patients usually stay in the surgical recovery area following cervical disc replacement surgery until they are recovered from anesthesia. Pain is managed with medications and most patients stay in the hospital one or two days. During hospitalization:

  • Fluids are continued in the intravenous line until the patient can take liquids without any problems by mouth.
  • As the ability to swallow returns, the diet is advanced until the patient has resumed their normal diet
  • Pain medications are given as needed
  • Nurses monitor the incisional dressing, help patients to get out of bed and use the bathroom
  • Support collars are sometimes worn while in the hospital
  • Patients are usually encouraged to be up and out of bed as much as possible

Recovering at home and rehabilitation after cervical disc replacement surgery may include the following:

  • Most patients are able to eat their normal diet
  • Some patients are instructed to wear a neck collar or brace
  • Depending on the type of sutures used, you may need to see your surgeon to have these removed
  • Most patients can shower fairly soon after surgery. You will be instructed about how to care for your incision
  • Many patients start physical therapy a few weeks after cervical disc replacement surgery
  • Most patients are able to resume their normal activities within 6 weeks after surgery

If you have any of the following problems after cervical disc replacement surgery, notify your surgeon:

  • Signs of infection in your incision: Redness, foul discharge, bleeding, swelling, odor, increased pain
  • Headache
  • Fever
  • Pain that is not relieved by  your pain medication
  • Increased weakness or numbness
  • Difficulty breathing
  • Difficulty swallowing
  • Difficulty talking, a change in your voice, or hoarseness