Artificial Cervical Disc Replacement
Why is this surgery done?
Artificial discs are an alternative to fusion. The goal of surgery remains the same: to get the pressure off the nerves or spinal cord to relieve the symptoms. The difference is that once this goal has been achieved, an artificial disc maintains motion at that level, whereas a fusion stops or severely limits motion at the surgical level.
How is artificial cervical disc replacement done?
An incision is made on the front of the neck and then the tissue planes are separated, until the surgeon gets down to the front of the spine. The disc is then removed slowly in small pieces, and the pressure is pulled away from the spinal cord and/or nerve roots. An artificial disc, which can be made from many different materials depending on the manufacturer, is put into the space where the disc once was. This artificial disc has to be precisely placed so that it provides similar motion to the original disc.
What are my risks? What are common complications?
Risks of surgery in general are death, bleeding and infection. Risks specific to this surgery include:
- Swallowing difficulty
- Vascular injury
- Continued or worsening pain
- Numbness or weakness
- Failure or loosening of the artificial disc requiring revision surgery
- New weakness that wasn’t present prior to surgery
- Infection of the device requiring removal and conversion to a fusion surgery
What do I need to know before surgery?
Surgery is a patient’s choice. We are giving you our recommendation to help you with your symptoms, but there are no guarantees that the surgery will give you the results you are hoping for.
Healthy nutrition plays a huge role in the healing process. Patients who have a healthy diet, exercise regularly and do not smoke have far better surgical results than those who don’t take proper care of their health.
General discharge instructions
After you return home and are fully mobile, you may remove the support hose worn on your legs.
Your surgeon may give you a cervical collar for comfort. However, wearing the collar is not required. Your surgeon will clarify the instructions for wearing your collar. You may discover that wearing it while riding in the car is helpful, for example.
You will leave the hospital with a waterproof dressing on your incision site. This dressing should remain in place for two days after you return home. Under the dressing will be Steri-Strips, which are small adhesive strips across the surgical incision. Leave these Steri-Strips on the incision and allow them to fall off naturally; this usually occurs within two weeks. If after two weeks the Steri-Strips have not fallen off, you should remove them.
After removing the dressing, your incision can be open to the air. It is important for a family member to look at your incision each day for one week after surgery to watch it for any changes as the healing process continues.
You may shower any time after surgery, but pay attention to your body and do not shower if you are feeling lightheaded or tired. Simply pat your incision dry after your shower and leave the incision open to the air under your clothing.
Do not take tub baths or Jacuzzi baths and do not go swimming for the first three weeks after your surgery.
General anesthesia, inactivity after surgery and pain-relieving prescription narcotics may cause constipation after surgery. It may be helpful to take a stool softener and/or laxative after surgery. These medications, which include Colace, Miralax and Senokot, may be purchased over the counter at your local pharmacy.
What should I expect while recovering?
Some people heal and recover faster than others. We are all different and our problems are rarely exactly the same, no matter how similar they may seem. Surgery is not typically very painful and not everyone takes postoperative narcotics for this operation. It is important to avoid any movements or activity that put significant strain on your neck early in the healing process. Surgery can be done as an outpatient or with an overnight stay, depending on your overall health and certain other criteria. We want patients up and moving as soon as possible to avoid blood clots and to keep your muscles from getting weak. Some nerve symptoms improve immediately and some take a long time to recover. If there is nerve damage or a spinal cord injury, you may not see a significant improvement with surgery. Your surgeon and his/her team will guide you through the recovery process and give you expectations about what activities are safe to perform postoperatively at the different time intervals.
Possible physical therapy exercises
Some patients will see significant benefit from working with a therapist, while other patients who are more athletic may do fine with a list of acceptable postoperative activities given to them by their surgeon or their team. Those decisions are individual and will be made with your surgeon postoperatively.
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