What is cervical disc surgery with prosthesis and what is the necessity? Prosthetic cervical disc surgery means replacing the damaged cervical disc with an artificial disc. The necessity of this operation arises when non-surgical treatments such as physiotherapy, drug therapy or specialized injections cannot reduce the pain and pressure on the nerves. This pressure usually leads to symptoms such as chronic neck pain, spreading pain to the hands, muscle weakness or even organ dysfunction. Prosthetic surgery, such as microscopic cervical disc surgery, in addition to relieving pressure on the nerves, allows for the return of normal neck movements, unlike fusion, which fuses the vertebrae together and limits the range of motion of the neck. What are the types of cervical disc prosthesis? Cervical disc prostheses are designed in such a way as to provide the necessary strength and flexibility after **cervical disc surgery**. These prostheses are divided into two general categories: fully mobile prostheses, which simulate the natural movements of the disc, and semi-mobile prostheses, which are less flexible but offer more stability. ### Artificial disc prosthesis and fusion (vertebral fusion) Artificial disc prosthesis and fusion are two different approaches for cervical disc treatment, each of which has its own advantages and disadvantages. In the fusion method, the damaged vertebrae are welded together and the movement in that part of the neck is stopped. This helps reduce pain, but it limits the mobility of the neck and may put more pressure on other vertebrae. On the other hand, cervical disc surgery with prosthesis by replacing the destroyed disc preserves the normal movements of the neck and improves the quality of life of patients. ### Types of prostheses Cervical disc prostheses are usually made from a combination of materials such as metals (titanium or cobalt chrome) and resistant medical polymers such as high density polyethylene. Metals are responsible for strength and stability, while polymers play the role of simulating the soft and flexible properties of the natural disc. The choice of the type of prosthesis depends on the patient's bone conditions, possible allergies and expected life span. > In an article published in the *Spine Journal* it is stated: "Cervical disc prostheses, which are made of a combination of metal and polymer, have shown higher wear resistance and a better ability to maintain neck motion compared to all-metal prostheses." source ### New technologies in prostheses With the advancement of technology, cervical disc prostheses have also improved day by day. The new generations of these prostheses have features such as anatomical design in accordance with the structure of the vertebrae, anti-wear coatings, the ability to adapt to multi-axis movements and reduce the possibility of loosening in the long term. Some modern prostheses are even made using 3D printing technology to have the most adaptation to the patient's body. Also, the use of bioactive coatings helps the bones integrate with the prosthesis faster. Procedures for neck disc prosthesis surgery This operation is performed through detailed and specialized steps that require high skill of the surgeon and advanced equipment. In short, first the patient is under anesthesia and then the damaged disc is removed and the prosthesis is replaced. The steps include: - General anesthesia: the patient is completely anesthetized for surgery. - Creating a surgical incision: a small incision is made in the front of the neck. - Removal of muscles and tissues: soft tissues are removed to access the vertebrae. - Remove the damaged disk: the damaged disk is completely removed. - Preparation of the intervertebral space: the disc site is prepared for the placement of the prosthesis. Prosthesis placement: the selected prosthesis is placed in the prepared space. - Final control and closing the incision: after ensuring the correct placement of the prosthesis, the incision is closed. Pre- and post-operative care Before and after neck disc surgery with prosthesis, it is very important to follow care points. Before the operation, the patient must perform the necessary tests, including MRI imaging or CT scan, so that the surgeon has a complete view of the spine. Also, the use of medicines such as blood thinners should be stopped with the doctor's opinion. After the operation, relative rest, avoiding sudden movements of the neck, taking prescribed drugs and participating in physical therapy sessions are mandatory. Patients can usually return to daily activities within a few weeks, but return to heavy sports or high-risk activities should be done with the doctor's opinion. Possible complications and risks of cervical disc surgery with prosthesis Although cervical disc prosthesis surgery is a safe and effective procedure, like any other surgery, it comes with some risks. Possible complications include surgical site infection, bleeding, damage to nearby nerves, loosening or displacement of the prosthesis, and the body's reaction to the prosthetic materials. In rare cases, the patient may still have pain or limited movement after the operation. There is also the possibility of problems in the adjacent vertebrae, although the rate is much less compared to the fusion method. Being aware of these complications and careful consultation with the doctor will help the patient to make a more informed decision. Advantages and disadvantages of cervical disc prosthesis **Summary** An advanced and effective method for the treatment of serious cervical disc problems is cervical disc surgery with a prosthesis, which simultaneously reduces pain and pressure on the nerves, and provides the possibility of maintaining the normal movement of the neck. Compared to traditional methods such as fusion, this operation has significant advantages and helps patients to return to daily life faster. Despite this, it is very important to be aware of possible complications and observe pre- and post-operative care. Finally, the choice of this method should be based on the specific conditions of each patient and the diagnosis of a specialist doctor. If you are looking for an effective treatment with minimal movement restriction, cervical disc prosthesis can be a smart choice after receiving advice from Dr. Yazdan Panahi.