Cervical Artificial Disc Replacement
What is an artificial disc?
The disc is the soft cushioning structure located between the individual bones of the spine, called “vertebra.” It is made of cartilage-like tissue and consists of an outer portion, called the annulus, and an inner portion, called the nucleus. In most cases, the disc is flexible enough to allow the spine to bend. An artificial disc is a device that is implanted into the spine to replace the disc and then imitate the functions of a normal disc, therefore preserving motion.
Artificial discs are usually made of metal or plastic-like (biopolymer) materials, or a combination of the two. These materials have been used in the body for many years. Total disc replacements have been used in Europe since the late 1980s. The most commonly used total disc replacement designs have two plates. One attaches to the vertebrae above the disc being replaced and the other to the vertebrae below. Some devices have a soft, compressible plastic-like piece between these plates. The devices allow motion by smooth, usually curved, surfaces sliding across each other.
Cervical Artificial Disc Replacement has been FDA-approved since 2007.
Who needs an artificial disc?
The indications for successful cervical artificial disc replacement may vary for each patient. Some general indications are pain arising from the disc that has not been adequately reduced with non-operative care such as medication, injections, chiropractic care and/or physical therapy. Each vertebra in the spine is separated by a disc, which is made up largely of water. As discs lose water content because of disease, injury or age, they compress, or lose height, which causes the vertebrae to move closer together. This reduces the disc’s normal functioning, which may lead to pain, bone spurs and narrowing of the nerve openings. If a disc ruptures, it can place pressure on the surrounding nerve roots and the spinal cord, resulting in pain, numbness and/or weakness.
Typically, you will have had an MRI that shows disc degeneration. Often you have a CT scan performed to verify the bony architecture of the joints and vertebrae. Dr. Arias will correlate the results of these tests with findings from your history and physical examination to help determine the source of your pain.
An artificial disc is a surgical implant indicated to treat patients suffering from degenerative disc disease (DDD) of the cervical (neck) spine. The most common design allows for a variable center of rotation, meaning the disc is designed to better replicate the motion of a naturally functioning cervical spine.
Who Can Benefit?
It is estimated that more than 200,000 patients receive surgical treatment for cervical DDD. Patients suffering from single-level cervical DDD with problematic radiculopathy which is arm pain numbness, tingling, and/or weakness from a pinched nerve in the neck related to a herniated disc. Many patients will also have some element of neck pain going along with it. Patients may also have bone spurs causing irritation of the nerve root, with arm pain and/or neck pain.
Traditional Spinal Fusion
Spinal fusion is the current standard of care for patients suffering from DDD. It is a widely used and successful therapy that shows a 95% success rate based on radiographic imaging. However, fusions restrict motion at treated levels and literature suggests that it may cause additional complications at adjacent levels of the spine. An artificial cervical disc design allows for preservation of motion at the treated level and is an effective and safe treatment for many patients. Spinal fusions will still be indicated for certain patients, but there now exists another option for patients suffering from DDD.