Q&A Topic: Cervical Spine Disc Replacement
Marshal D. Peris, MD, FAAOS
Q. What type of pain or discomfort may indicate that I can benefit from cervical spine disc replacement?
A. The cervical spine is in the neck, its seven vertebrae separated by discs. Because disc malfunction can impact the spinal cord, it can cause problems throughout the body. You may experience neck or arm pain, weakness in the arms, numbness and tingling in the arm or hand, or balance problems. Symptoms can be intermittent, chronic, or triggered by specific activities.
Q. What conditions of the cervical spine cause these symptoms?
A. Ultimately, all symptoms result from compression of the spine or the nerves exiting the spinal cord due to stenosis, or narrowing. This occurs in various ways. As you age, your spinal discs lose height (that’s why we all get shorter), causing them to bulge. Picture gently squeezing down on a cream donut: It gets shorter, but also wider. A bulging disc can press on a nerve exiting the spinal cord. At a later stage, the bulge can harden (calcify) into a bone spur, which can also compress a nerve. In the case of a herniated disk, now you are squeezing the cream donut so hard that cream leaks out. This disc material can put direct pressure on a nerve.
Q. When is cervical disc replacement the best course?
A. The traditional approach to painful nerve compression due to cervical disc damage is the fusion procedure, in which the disc is removed and the surrounding vertebrae are permanently locked together. While fusion offers excellent results, the newer procedure of cervical spine disc replacement goes a step better for suitable candidates: By replacing the damaged disc with an implant closely resembling a human disc, it maintains the mobility of the cervical spine; in some cases, even improving motion. The best candidates are active people under 60 years, who want to maintain a full range of motion. While documented outcomes are positive for 15 years, there is not yet any long-term data.
Q. What can I expect if I have this procedure?
A. Through a small incision in the front of the neck, the surgeon removes the bad disc, including any bone spurs and disc material touching the spinal cord or nerves, and puts in the implant(s). You will likely go home the same day, take certain precautions for six weeks, then resume full activities. My surgical colleagues at Northern Westchester Hospital and I are performing sophisticated spinal procedures for the treatment of disc problems and are using the most advanced cervical spine disc replacement procedure, which permits the implanting of two discs at once.
Northern Westchester Hospital
Co-Director, Spine Surgery
Orthopedic and Spine Institute
Learn More About Dr. Peris
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