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Cervical Disc Replacement

What is Cervical Disc Replacement?

Cervical disc replacement surgery is a procedure used to treat neck pain and other symptoms related to problems with the discs in the cervical spine, which is located in the neck. Similar to lumbar disc replacement in the lower back, this surgery involves replacing a damaged or diseased cervical disc with an artificial disc. The goal is to relieve pain, preserve motion, and maintain more natural neck movement compared to traditional methods like spinal fusion.

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An artificial disc surgery may be done instead of an anterior cervical discectomy and fusion. The theoretical advantages of the artificial cervical disc over a fusion include:

  • Maintaining normal neck motion
  • Reducing degeneration of adjacent segments of the cervical spine
  • Eliminating the need for a bone graft
  • Early postoperative neck motion
  • Faster return to normal activity

There are currently a number of artificial disc technologies undergoing clinical trials in the US to evaluate their safety and effectiveness. Various cervical artificial discs are in use outside the United States, with the oldest prototype device dating back to the early 1990s in England.

Why Might You Need Cervical Disc Replacement?

Cervical disc replacement surgery would most typically be done for patients with a cervical herniated disc that have not responded to non-surgical treatment options and are significantly affecting the individuals’ quality of life and ability to function. 

Many people may experience neck, shoulder, and/or arm pain in their lifetime due to disc abnormalities in the neck. These complaints can be signs of disc herniations or disc degeneration, and/or arthritis of the neck.

The cervical spine (neck) is composed of vertebral bodies (the bony building blocks of the spine) and intervertebral discs, which act as combination universal joints and shock absorbers between the vertebrae. With time, the discs can become worn out and cause pain and/or other symptoms, a condition typically referred to as degenerative disc disease, a subgroup of which will include cervical disc herniations. This means the disc becomes compressed, frayed, and/or herniates into the adjacent spinal canal where it can press on nerves or the spinal cord.

Most patients with these types of symptoms do not need surgery. They typically can improve with conservative (non-surgical) treatment, which may include anti-inflammatory medications, physical therapy, or cold/heat therapy. Over 90% of patients will experience pain relief with these modalities within four to six weeks.

What Does the Procedure Involve?

An artificial cervical disc is a device inserted between two cervical vertebrae after an intervertebral disc has been surgically removed in the process of decompressing the spinal cord or a nerve root. The intent of the device is to preserve motion at the disc space. It is an alternative to the use of bone grafts, plates and screws in pursuit of a fusion following such a disc removal, which necessarily eliminates motion at the operated disc space in the neck. 

Additional Treatments

Anterior Cervical Discectomy and Fusion

If a person continues to have significant neck pain and/or radicular arm pain (meaning that the pain is “shooting” down from the neck into the arm) after a trial of conservative treatment, then he or she may be a candidate for cervical spine surgery. An anterior discectomy and fusion is the most common operation for treating patients with symptoms related to a degenerative or herniated disc in the neck.

Neck Pain

This procedure consists of removing the problem disc entirely and replacing it with a piece of bone taken either from the patient’s hip or a human cadaver. A metal plate with screws and/or a cervical collar may also be used to help hold the bone in place and to allow this segment of the neck to fuse together. The purpose of an anterior cervical discectomy and fusion surgery is twofold:

  • To remove the offending agent – either the herniated disc or the osteophytes that are compressing the nerves and/or spinal cord.
  • To eliminate motion by inducing a fusion at the disc space where the disc has been removed, aided by the use of bone grafts and possibly plates/screws, etc. and thereby creating stability and/or eliminating pain associated with the motion.

How Effective is Cervical Disk Replacement?

This type of surgery typically improves the pain in over 90% of people with one-level disease. However, there are potential complications in using bone grafts in pursuit of a fusion. Harvest of one’s own bone may be associated with both acute and potentially long-term pain from the donor site. Any type of bone graft may fail to heal, resulting in a so-called ‘non-union’, which may require another fusion operation. Sterile bank bone (cadaver bone) is more convenient and not associated with donor site complications, but it tends to heal a lesser percentage of the time. Studies have also shown that by fusing a segment of the spine, the levels of the spine above and below the fused area are now forced to absorb more load since there is no longer any intervening motion shock absorption. These adjacent levels will then wear out and become symptomatic in more than 25% of these patients within ten years, meaning possibly more surgery. This is called adjacent-segment degeneration.

The development of artificial cervical discs is intended to accomplish the same objectives as the traditional decompression and fusion surgery in terms of providing pain relief and stability, but with fewer drawbacks. For example, the cervical artificial disc does not include the potential complications involved with using bone graft (e.g. ‘non-unions’) and theoretically should lessen the risk of developing adjacent-segment disc degeneration or disease.

Orthopedic Spine Surgeon Dr Hamid R. Mir M.D.

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Dr. Hamid R. Mir M.D.

Orthopedic Spine Surgeon & Back, Spine, & Neck Specialist

Dr Hamid Mir is a board certified orthopedic spine surgeon & back, spine, & neck specialist with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in Orange County, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.

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Testimonials

You are more than just a patient.

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I was in a very bad situation with a herniated disc in my lower back so I made an appointment with DISC spine center and Dr. Hamid. He was very professional and made me comfortable that he understood exactly what I was going through and was able to communicate effectively exactly what it will take to get me on the road to recovery after spine surgery. It took several months as my injury was severe however I always felt I was in good hands under Dr. Hamid’s supervision…If you ever have the misfortune of injuring your circuit board of your body (spine) you need a pro, do not take advice from anyone who’s not specifically licensed to help, Dr Hamid is who I chose and I’m very thankful.

- Matteo B

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Dr. Mir saw me about 2 months before the spine procedure and indicated that I had severe stenosis or narrowing of the openings where the nerve roots exit at the L4, L5 and S1 level. He reviewed my MRI and without wasting any time, asked if I wanted or was considering spinal surgery. He was extremely clear and answered all my questions. I had the procedure done at the Disc Newport OP surgery spine center and was cared for by an incredibly competent, caring staff. I was discharged same day and my post op recovery was 2 weeks, and returned to daily activities and work July 15th. The procedure was very successful as my back pain is basically gone. Amazing relief from a procedure done by a great surgeon with a great team!

- Stan W.

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Dr Mir is an excellent spine surgeon. I had a surgery on my neck by another surgeon but I was still in pain. A friend who had prior spine surgery with Dr. Mir recommended him to me. As the treating surgeon he was very detail oriented, confident, and knowledgeable. His team is very friendly and helpful. I decided to have a second cervical spine operation on my neck. Soooo thankful I have no pain and for physical medicine doctors like him.

- Hillary C.

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Dr. Mir and his entire team of specialists take the extra time and consideration to shape alternatives to meet the needs (holistically) of the patient. Everything about the experience of my surgery was positive. Dr. Mir is a patient and compassionate surgeon. His communication skills are remarkably attentive. We are six months out of the starting gate from surgical treatment, and with PT and core strengthening exercises, this 65 yr. old is back to regular training for next year’s marathon. Thank you kindly El Doc-tor….you are amazing! See you soon.

- Lorena B.

Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.

Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.

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