Cervical Disc Arthroplasty
Sometimes it is necessary to replace a damaged disc, in which case, an artificial disc may be used. In general, there are two types of disc replacement which may occur:
- Total disc replacement
- Disc nucleus replacement
Total Disc Replacement
Artificial discs are typically made of either metal or plastic-like materials like biopolymers, or a combination of these materials.
The most commonly-used designs use two plates, one attaching to the vertebrae above the disc being replaced, and the other to the vertebrae below it.
Disc Nucleus Replacement
These usually use biopolymer materials, including substances such as hydrogel, which expands as it absorbs water.
It is placed in the nuclear cavity of the disc and, upon hydration, expands to fill the cavity. Its compressibility allows a range of motion much like a normal disc.
Other discs use a biopolymer that coils around to fill the nuclear cavity.
However, no nuclear replacement devices are currently available for use in the United States at this time.
Who Is Eligible for Disc Replacement?
Candidates for total disc arthroplasty are patients who have back pain that has not responded to other non-surgical treatments, who have clear symptoms of disc degeneration.
Disc replacement uses the anterior (frontal) approach, through the abdomen, which may make prospective candidates ineligible, depending on their condition.
Other conditions that may prevent receiving disc replacement include:
- Spondylolisthesis (disc slippage)
- Allergy to artificial materials
- Spinal tumor
- Autoimmune disorders
- Chronic steroid use
- Previous abdominal surgery
Surgery is usually not considered for disc-related back pain unless the patient has been in severe pain for a prolonged period of time (at least six months), and nonoperative treatments and procedures have proven ineffective.
Total disc replacement offers an advantage over the more traditional approach of spinal fusion in that is allows the patient a more rapid return to activities they previously enjoyed.
Artificial discs are intended to offer a range of motion to patients who receive them.
The nature and severity of the patient’s pain indicates the type of artificial disc to use.
The less severe the degeneration of the disc, the likelier that nucleus replacement may be considered, where available. In cases of pronounced degeneration, total disc replacement is likelier.
Complications with total disc replacement are similar to those with spinal fusion.
These may include:
- Nerve injury
- Damage to blood vessels
- Wear and tear of artificial materials
- Breakage of the instrumentation
- Continued pain
- Sexual dysfunction
It is important to discuss your options thoroughly with your doctor before considering spine surgery.