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Cervical artificial disc replacement
مقاله تخصصی

Cervical artificial disc replacement

3 months ago
231 بازدید
Dr. Mahmoud Yazdan Panahi

Dr. Mahmoud Yazdan Panahi

Tehran

Neurosurgeon and spine and disc surgeon

What is an artificial neck disc and how does it work? Artificial cervical disc is an advanced medical implant that is used in **prosthetic cervical disc surgery** to replace the damaged disc between the cervical vertebrae. This method is performed with the aim of maintaining the natural movement of the cervical spine, reducing the pressure on the nerve roots and relieving the patient's pain. Unlike fusion surgery, in which the vertebrae are welded together, the use of an artificial disc allows the patient to maintain the range of motion of his neck and prevent the occurrence of complications due to the limitation of movement. In this method, two metal plates are connected to the vertebrae and the central core of the disc simulates the natural movements of the neck and prevents damage to the adjacent vertebrae by distributing the pressure evenly. Who is a candidate for cervical artificial disc replacement surgery? Correct patient selection for artificial cervical disc replacement surgery is of critical importance and requires careful medical evaluation. In general, the ideal candidate for this surgery is someone who suffers from: 1. Radiculopathy: pain, numbness, weakness in the arm 2. **Myelopathy**: Problems with walking, balance or hand function, caused by compression of the nerve or spinal cord by one or two damaged cervical discs. Before any procedure, it is necessary that the patient has tried conservative treatments such as physiotherapy, drug therapy and injections for at least 6 to 12 weeks and these treatments have not been successful. In addition, MRI and CT images play an important role in patient selection. These images should show that only one or two discs are affected and that the vertebrae are healthy and stable, without severe arthritis, extra large bone, or instability. Also, patients with severe osteoporosis, spinal infection, tumor, or severe spinal deformity are usually not suitable candidates for this surgery. Possible risks and complications of cervical artificial disc Every **neck disc operation**, be it fusion or disc replacement, comes with its inherent risks, and **artificial neck disc replacement surgery** is no exception. Common complications of surgery include surgical site infection, bleeding, adverse reactions to anesthesia, and minor nerve damage (such as damage to the recurrent laryngeal nerve, which can lead to voice changes) or damage to the esophagus (dysphagia or difficulty swallowing). Although these complications are rare, they are always part of the risks of any surgery and should be fully discussed with the patient. In addition to the general risks of surgery, artificial cervical disc may have certain complications. This includes the displacement of the disc, its sinking into the vertebrae, the growth of extra bone that limits the movement of the neck, and in very rare cases, the fracture or erosion of the prosthetic parts. However, studies show that the risk of damage to surrounding vertebrae after artificial disc replacement is about 50% lower than anterior cervical fusion. Choosing the right patient and performing surgery with the correct technique can reduce these risks. Preparation before artificial cervical disc replacement surgery For the success of cervical artificial disc replacement surgery, preoperative preparations are very important. The doctor usually asks the patient to do imaging tests such as MRI or CT scan to determine the exact location of the injury and the condition of the vertebrae. It is recommended to stop taking blood thinners, adjust your diet and avoid smoking in the weeks before surgery. The patient should inform the doctor of his medical history, allergies, medications and any special symptoms. It is also possible to have a consultation session with an anesthetist and the necessary training for the day of the operation and aftercare to ensure the safety and effectiveness of the surgery. Artificial cervical disc replacement procedure (**CDR**) Familiarizing yourself with the process of artificial cervical disc replacement (CDR) will inform you about the progress of the treatment process and you can go through this process with more confidence. We have included the most important steps for you in the list below. - **General anesthesia:** The patient is completely anesthetized so that he does not feel any pain during the surgery and the anesthesia team controls the vital signs. **Incision in the front of the neck:** A small incision is made in the front of the neck to access the spine without damaging the tissues. - **Removal of the damaged disc:** The worn or compressed disc is carefully removed to remove the pressure from the nerves and spinal cord. - **Preparation of the space between the vertebrae:** The empty space between the vertebrae is cleaned and prepared so that the artificial disc can be properly placed in its place. - ** Placement of the artificial disc:** A replacement metal and polyethylene disc is implanted in place to maintain the natural movement of the vertebrae. - **Closing the surgical incision:** After ensuring the correct placement of the disc, the incision is carefully sutured and bandaged. - **Recovery care:** The patient is monitored to check vital signs and reaction to anesthesia. - **Discharge and home care:** The patient is discharged after a few hours or a day with prescriptions for medication, physiotherapy and movement care. Introduction of artificial neck disc prostheses The technology of making artificial cervical discs has made significant progress over many years, and today, various types of these prostheses are available with different designs, materials, and movement mechanisms. The ultimate goal of all these designs is to restore normal motion and stability to the cervical spine, but each has unique features that may be more appropriate for specific patients and clinical conditions. The choice of the type of prosthesis depends on several factors, including the patient's anatomy, the number of surfaces involved, and the surgeon's preferences. ### ProDisc C cervical disc prosthesis Charité disc prosthesis Mobi-C cervical disc prosthesis Prestige LP cervical disc prosthesis activL cervical disc prosthesis Simplify cervical disc prosthesis M6-C cervical disc prosthesis M6-C is an artificial cervical disc that simulates the movement and function of a natural cervical disc. Its central core is made of urethane polycarbonate and the outer ring is made of polyester fibers to absorb pressure and shocks. This prosthesis allows movement in six directions and gives you a sense of comfort and stability in the neck, so that the recovery period is spent with minimal movement restrictions. What happens after artificial cervical disc replacement surgery? After artificial cervical disc replacement, the patient is transferred to the recovery room to monitor vital signs and the body's response to anesthesia. Most patients can move and even walk within *24 hours*. Postoperative pain is usually controlled with painkillers, and depending on the patient's condition, physical therapy may be required. Unlike the fusion operation, the movement between the vertebrae is preserved and the healing process is faster. Similar to discectomy surgery, the main goal in this method is to reduce pressure on nerve roots and restore neck function. Patients should refrain from heavy activities and follow the doctor's instructions. What are the advantages of artificial cervical disc replacement surgery? Unlike the fusion procedure, which causes the vertebrae to fuse together and lose motion between them, cervical disc replacement surgery allows the vertebrae to continue to move normally. The artificial disc is designed to maintain the flexibility and rotation of the vertebrae like a natural disc. This feature is very important for patients who lead an active lifestyle or care about neck range of motion. Maintaining the normal movement of the neck is not only effective in the comfort of the person, but also prevents unnecessary pressure on the adjacent vertebrae. ### Reducing pressure on nerves and reducing pain One of the main goals of cervical disc replacement surgery is to take pressure off the nerve roots that cause neck, shoulder, or arm pain. When the damaged disc is removed and replaced with an artificial disc, the pressure is removed from the nerves and the symptoms of pain, numbness, or tingling gradually decrease. This reduction in nerve pressure improves the quality of life, increases mobility and reduces dependence on painkillers. Many patients report significant pain relief in the first few weeks after surgery. ### Faster recovery than Fusion Disc replacement surgery is usually associated with a shorter recovery period than fusion. Because there is no need to fuse the vertebrae, the patient can resume his daily activities sooner. Many patients are able to walk within a few days after the operation and return to work and normal life a few weeks later. This quick recovery is a very important advantage, especially for people who cannot be away from work or social activity for a long time. ### Reducing the possibility of damage to adjacent discs In the fusion procedure, because the movement between the two vertebrae is lost, additional pressure is applied to the adjacent discs and the possibility of their premature erosion increases. But in neck disc replacement surgery, the normal movement of the vertebra is maintained and the load is distributed between the vertebrae in a natural way. As a result, the risk of damage or premature degeneration of adjacent discs is greatly reduced. This will make the spine more stable in the long term and reduce the need for further surgeries in the future. ### Improving neck movement function By replacing the damaged disc with an artificial disc, the patient is able to move his neck more easily. Unlike fusion, which limits range of motion, this surgery allows for normal neck flexion, rotation, and extension. This advantage is especially valuable for people who need full neck movement in daily activities such as driving, working on a computer, or playing sports. Improving motor function increases self-confidence, reduces dependence on others and returns to normal life faster. ### Reducing the need for additional surgeries Due to the precise design of artificial discs and maintaining the dynamics of the spine, patients are less exposed to secondary injuries after cervical disc replacement. This makes it possible to reduce the need for re-surgery or other therapeutic interventions in the long run. Unlike fusion, which sometimes needs to be modified or strengthened after a few years, in the CDR method, the useful life of the disc is long and its function remains stable in most patients. This advantage is particularly important in terms of cost and comfort for the patient. Complications of artificial cervical disc replacement Examining the complications of artificial cervical disc replacement before surgery allows you to make a confident and decisive choice. Note that the severity and durability of these side effects can definitely be lower due to the level of experience and expertise of the doctor, so it is necessary to choose the best specialist for this operation. 1. Surgical site infection 2. Bleeding during or after surgery 3. Shifting or slipping of the artificial disc 4. Damage to the cervical nerves 5. Long-term neck pain or stiffness 6. Fracture or erosion of artificial disc 7. The body's reaction to a foreign object 8. The need for re-surgery 9. Problems in swallowing or voice 10. Limited range of motion in certain cases How successful is artificial cervical disc replacement? Artificial cervical disc replacement is one of the most successful treatment methods for advanced cervical disc problems. According to valid clinical studies, the success rate of this surgery has been reported between *85 and 95%*. More than *90%* of patients experience a significant reduction in neck, shoulder and hand pain after the operation; Also, compared to fusion surgery, patients maintain a better range of motion after disc replacement. Unlike some limited methods such as cervical disc surgery with laser, which is mostly used for mild problems, artificial disc replacement for advanced cases brings more stable and reliable results. How long is the recovery period after artificial cervical disc replacement? The recovery period after artificial cervical disc replacement is shorter than traditional methods such as fusion. Most patients are discharged from the hospital within *24 to 48 hours* and will be able to perform light daily activities after *1 to 2 weeks*. Full return to work or sports activities may take between *4 and 8 weeks*, depending on physical condition and adherence to medical advice. Physiotherapy, proper sleep and avoiding sudden neck movements are important during this period. By carefully following the rehabilitation program, patients can fully recover the normal function of the neck. The most important points to get the best result from artificial neck disc replacement In order to achieve the best result from artificial neck disc replacement, it is very important to strictly follow medical recommendations, perform physical therapy regularly, avoid high-risk movements, and have periodic follow-ups. Proper nutrition, smoking cessation, proper sleep and weight control are effective factors in faster recovery. Choosing an experienced surgeon also plays a key role; Because the precise implementation of the surgical technique and the correct choice of the type of artificial disc have a direct impact on the result of the operation. Dr. Mahmoud Yazdan Panahi, with extensive experience in spine surgeries and new methods such as disc replacement, is considered one of the reliable options to perform this specialized operation.
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