Vertebral discs are remarkable structures that allow motion and provide structure to the spine. However, as we age these discs degenerate. Intervertebral discs can become injured, sometimes in the form of a disc herniation. In the cervical spine, symptomatic disc degeneration or herniations are treated with discectomies and fusion. This is the gold standard.
Artificial disc replacement surgery is intended to remove the diseased disc, decompress the neurological structures, restore normal disc height, preserve motion in the affected area of the neck and improve patient function. The artificial disc replacements have been designed to maintain the physiological range of motion in the cervical spine. The implants were developed using the clinically proven ball and socket concept that has been used in traditional orthopedic joint replacement implants for over 40 years. Although an anterior cervical discectomy and fusion is still the gold standard operation for cervical disc herniation, it is possible that fusing 1 level of the spine may promote more rapid degeneration of the adjacent segments.
The theory behind artificial disc replacements is that by preserving motion at the diseased level, the adjacent levels are spared the undue stresses of a spinal fusion. This may limit the need for patients to have revision surgery, which can occur in up to 25% of patients who had surgical fusions in a 10-year postop follow-up period. Spinal surgeons are excited about this new technology and are hopeful that this can improve on the natural history of cervical disc degeneration. Cervical artificial disc replacements are becoming more and more popular and results are demonstrating equivalent outcomes compared with cervical fusion at the 2 and 5-year follow-ups. We don’t have longer-term follow-up data yet. This procedure is now an acceptable alternative for some patients with 1 or 2 level disease. All of the surgeons at Connecticut Neck & Back perform cervical disc replacement surgery.