Our Summary

This research paper discusses the increasing popularity and success of a surgery known as anterior cervical disc replacement (or arthroplasty) over the past 20 years. This procedure uses a ball-and-socket device to mimic the natural movement of the neck, which has been shown to produce results that closely resemble healthy, normal neck motion. While a different surgery called anterior cervical discectomy and fusion has been used safely and effectively for many years, this newer procedure has some advantages. It maintains more natural movement in the neck, can potentially lessen further joint damage, and doesn’t require the use of plates or bone grafts. The paper suggests that more and more research is backing up the effectiveness and long-term success of this disc replacement surgery.

FAQs

  1. What is anterior cervical disc replacement (arthroplasty) and how does it work?
  2. What are the potential benefits of cervical disc replacement over anterior cervical discectomy and fusion?
  3. What evidence supports the success and longevity of arthroplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to follow post-operative instructions carefully, including avoiding heavy lifting and strenuous activities, maintaining good posture, and attending physical therapy to help with recovery and prevent future issues. It is also important to keep up with regular follow-up appointments to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for discectomy are those who have not responded well to conservative treatments such as physical therapy, medication, and injections, and who continue to experience symptoms such as severe pain, weakness, numbness, or tingling in the neck, arms, or hands. Candidates for discectomy may also have a herniated or degenerated disc in the cervical spine that is compressing the spinal cord or nerve roots, leading to symptoms such as radiculopathy or myelopathy. Additionally, patients who have failed to improve with non-surgical treatments and who have evidence of cervical disc degeneration or herniation on imaging studies such as MRI may also be recommended for discectomy.

Timeline

Before discectomy:

  1. Patient experiences neck pain, arm pain, numbness, tingling, and weakness due to a herniated disc in the cervical spine.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, and nerve conduction studies to confirm the diagnosis.
  3. Patient may try conservative treatments such as physical therapy, medications, and injections to manage symptoms.

After discectomy:

  1. Patient undergoes anterior cervical discectomy and fusion or disc replacement surgery to remove the herniated disc and relieve pressure on the spinal cord and nerves.
  2. Recovery period involves pain management, physical therapy, and restrictions on activities to allow the spine to heal.
  3. Over time, patient experiences decreased neck and arm pain, improved mobility, and a return to normal activities.
  4. Long-term follow-up may involve monitoring for any complications or the development of adjacent segment degeneration.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy procedure?
  2. How long is the recovery period after a discectomy surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What are the long-term outcomes of a discectomy compared to other treatment options?
  5. How soon can I return to normal activities, such as work or exercise, after the surgery?
  6. Are there any restrictions or limitations I should be aware of after the surgery?
  7. How likely is it that I will need additional surgery in the future after a discectomy?
  8. What are the success rates of discectomy surgery in relieving pain and improving function?
  9. Are there any alternative treatment options to consider before proceeding with a discectomy?
  10. How experienced are you in performing discectomy surgeries, and what is your success rate with this procedure?

Reference

Authors: Steinberger J, Qureshi S. Journal: Neurosurg Clin N Am. 2020 Jan;31(1):73-79. doi: 10.1016/j.nec.2019.08.009. Epub 2019 Oct 24. PMID: 31739932