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If you’re experiencing arm pain (radiating, burning, tingling and numbness) along with neck pain it’s important to reach out to a spine specialist.  That set of symptoms could be a sign of symptomatic nerve or spinal cord compression. If non-operative treatment options like anti-inflammatory medications, physical therapy, exercise, weight loss or spinal injections don’t fix your problem, it may be time to consider a disc replacement.

A cervical disc replacement can be an excellent option for many candidates. This type of spine surgery involves removing the damaged disc and replacing it with an artificial disc that very closely resembles the motion of a  human disc. This modern surgical procedure improves strength, resolving numbness and associated arm symptoms (ie; arm weakness, tingling, burning, numbness). Its success rate is over 95 percent.

So who is the best candidate for this type of procedure and how is it done? Here are 5 common questions – and answers – about disc replacement. 

1) What is disc removal?

Discs hold the vertebrae of the spine together and act as shock absorbers during movement. When the function of a disc is compromised {i.e. disc herniation, collapsed disc, etc.} it can result in a number of symptoms including pain, numbness, and tingling.

Sometimes it is necessary to completely remove the disc (which is performed through the front of the neck) and place an implant into the space once occupied by the disc. If an implant is not placed there, the spine would have too much movement and the disc space would collapse leading to a host of other issues.

2) Is this an alternative to a spinal fusion?

Yes. The gold standard has always been to achieve a fusion through the empty disc space. This is called an anterior cervical discectomy and fusion and it is achieved when bone forms together, through that empty disc space, and connect the two adjacent vertebrae. These two vertebrae then act as a single unit and hold the bones in a position that does not compress the nerves or cause any painful neck motion. 

Spinal fusions have been around for decades, but recently concerns have been raised that by changing the neck’s normal motion, the intervertebral disc next to the fused levels is then at risk of  degrading over time.

3) What is the difference between a fusion and disc replacement? 

When structures are ‘fused’ together, it limits motion; approximately 10 degrees of motion is lost in the neck per level fused. Even so, this is the right option for some people because their spinal segments are so worn out that removing motion is exactly what they need.

But a disc replacement is an attractive alternative for many people suffering from neck  pain where motion preservation is desirable. The technology developed for cervical disc replacement seeks to maintain neck motion that is similar to pre-surgical levels after the disc removal. Unlike fusion, maintaining motion in these cases does not add extra stress to the adjacent levels because the forces that occur during motion are evenly distributed across each level (rather than transferred to the adjacent levels), as it is meant to be.  

4) What are the differences in recovery time from the two procedures?

The act of fusion is the incorporation of that bone graft to the native bones surrounding the removed disc. This process takes time to heal and there are activity restrictions on average for three months during that crucial healing period.

Alternatively, a disc replacement is a newer option in spine surgery that involves less healing time. Without the need to wait for fusion incorporation, downtime is reduced after a disc replacement surgery, providing a quicker return to everyday life, activities, work, and sports and exercise.

5) How do I know if I’m a candidate for cervical disc replacement?

From a symptom perspective, you may have arm pain and numbness as well as neck pain. However, the specific type of neck pain is important. If it is determined that you have arthritic pain from joints in the back of the neck, called facet joints, then a disc replacement may not be appropriate for you. Unlike a fusion, which eliminates painful motion from the facets, disc replacement maintains motion. Therefore, neck pain may persist if a disc replacement is chosen.

Your imaging studies are also crucial. In addition to looking for arthritis in the facet joints, they show overall neck alignment. If your affected discs are collapsed and in a compromised position, then a fusion may be a better option.

IF YOU ARE INTERESTED IN LEARNING MORE ABOUT THE CERVICAL DISC REPLACEMENT TREATMENT OPTION FOR YOUR  NECK PAIN, SCHEDULE AN INITIAL CONSULTATION TODAY AT THE VIRGINIA SPINE INSTITUTE!

Dr. Colin Haines is a board certified spine surgeon and the Director of Research at Virginia Spine Institute. Dr. Haines performed the world’s first combined endoscopic and robot-guided spine surgery. His patient success has earned him a national feature on The Today Show and WebMD, and Top Doctor recognition in consecutive years.. Learn more about Dr. Haines.

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Reviewed by: Dr. Colin Haines, MD.

Reviewed by: Dr. Colin Haines, MD.

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