CERVICAL

ProDisc-C Animation

Degenerative Disc Disease, herniated disc and radiculopathy are very common conditions affecting the neck area or cervical spine. Degenerative disc disease of the cervical spine can lead to chronic neck pain. When a disc in the neck or cervical spine herniates, ruptures or becomes a disc protrusion, this can cause some pressure on the spinal cord, spinal nerves, or both. The terms disc herniation, disc rupture or disc protrusion mean the same thing and are used synonymously by various health professionals and lay persons alike.

When there is pressure on the spinal cord from a disc herniation, disc rupture or disc protrusion, the patient may experience neck pain, neck stiffness, shooting pains up and down the spine or even paralysis or weakness in the legs and urinary bladder. In severe cases, the spinal cord may need to be emergently decompressed to avoid permanent neurological damage.

A more common clinical pattern is when the disc herniation and/or bone spurs (osteophytes) are situated more laterally or to either or both sides. The herniated disc or bone spur can pinch a nerve as it is exiting the spinal canal trough the neural foramen. This can lead to pain in the shoulders or arms, numbness, pins and needles or even weakness of the arm on one or both sides. There may also be significant neck pain, shoulder pain and headaches. This clinical entity is called cervical radiculopathy. This may also lead to nerve damage but in most cases this is avoidable or even reversible through surgical treatment.

In the past, the only “tried and trusted” surgical treatment for severe cervical disc degeneration, cervical disc herniation or cervical disc rupture has been cervical fusion. This is where the diseased or herniated disc is removed and a bone graft or cage is placed in its place.  Eventually the vertebral body above fuses to the one below and motion at that segment is eliminated. This is a good and effective operation with good results except for the fact that there is no longer any motion. There may be a propensity for the disc above or the one below to later have problems. Also, there are some restrictions for a few months until the fusion becomes solid.

We now have the option of using an FDA approved device as an artificial disc replacement so that motion is retained. The surgery is similar in that the damaged, diseased or herniated disc is removed but instead of a bone graft or a cage, the artificial disc replacement device is placed. This device is capable of motion at that segment. There is an animation video available for viewing in this section above. To be a candidate for this procedure the patient must have only one disc involved. There are other criteria which may exclude certain candidates such as soft bone (osteoporosis) or cervical spinal instability or cervical facet disease.

Another advantage of this procedure is earlier return to work and earlier return to full and return to normal function. After surgery there is no need to wear a hard collar or brace. The artificial disc replacement device attains full stability long before a fusion construct and is stable enough to allow full activity sooner than a fusion.

Most insurance companies are currently approving and covering this procedure. The skill level required for this procedure is more exacting and a limited number of surgeons have been properly trained, certified and qualified to perform this operation. Surgeons at The Spine Center of Houston are certified in this procedure and fellowship trained by some of the original investigators that first implanted these devices in the USA. We have been successfully performing this procedure since the FDA first gave approval have been one of the first in Houston in this area. Please ask us to evaluate you for cervical artificial disc replacement if you are interested in this procedure. The procedure can be done on an outpatient basis in most cases.