Treatments

Introduction

Your surgeon will determine the type of surgery recommended for you depending on your MRI scan. If a disc is compressing a nerve (causing radiculopathy) or the spinal cord (causing myelopathy), then an anterior approach (front of the neck) would be recommended.

There are 2 types of anterior cervical surgery.  Both surgeries provide the same benefit of nerve or spinal cord decompression.

Artificial Cervical Disc

Description

ANTERIOR CERVICAL DISCECTOMY AND INSERTION OF ARTIFICIAL DISC. This is an operative procedure that involves removing the disc and inserting an artificial disc which is newer technology. 

Your surgeon will determine if you are a candidate for an artificial disc depending on your anatomy as seen on the neck x-rays. The advantage of an artificial disc is to preserve motion at the level thereby reducing the development of degenerative changes at the next segment of your spine.  The disadvantage of an artificial disc is that it is new technology with no long-term information available.

A small incision is made in the front of the neck, and the surgeon will remove the affected disc that is between the vertebrae and insert an artificial disc into the disc space.

Goals

For myelopathy: to remove the compression (decompress) the spinal cord to prevent your myelopathic symptoms from getting worse. 

For cervical stenosis: to decompress the spinal cord so as to avoid potential injury and/or prevent myelopathic symptoms.

For radiculopathy: to improve arm pain by removing the herniated disc and alleviating the pressure on the nerve.

Any neck surgery may not relieve neck pain and likely will not have any significant improvement of neuropathic pain.

After surgery

  • You will be admitted to hospital for one night.

  • You will have x-rays after surgery.

  • You will be seen by a Physiotherapist and an Occupational Therapist before discharge home.

Complications

As with any surgery, there are a number of potential risks and complications of Anterior Cervical Discectomy with insertion of Artificial Disc. Your surgeon will discuss the general risks of any operation and the specific risks related to your particular surgery.

  • General surgical risks of general anesthetic such as heart attack, pneumonia or stroke.

  • Specific risks with spinal surgery include infection, bleeding or CSF leak any of which could require a repeat surgery.

  • Specific risk of nerve root injury that may result in transient or permanent weakness, numbness or pain in right or left arm. There is a rare risk of spinal cord injury.

  • Specific risks include hoarseness and/or swallowing problems that are usually temporary and rarely permanent.

  • There is a rare risk of injury to the esophagus that could be potentially life threatening.

  • Specific risks of an artificial disc include risks of fusion at the surgical level as well as unknown long-term effects..

Recovery

Generally speaking, recovering after your surgery can take several weeks up to 3 months.

Return to Work: Talk to your surgeon about your expected time off work, about your ability to return to work and if there are any restrictions during your recovery time.

Recovery after myelopathy surgery: It is difficult to predict what degree of recovery (if any) to expect after surgery. Any potential neurological recovery (such as improved strength, improved balance, and/or change in sensation) can occur up to approximately 18 months.