An artificial cervical disc seeks to replace the movement and cushioning function of damaged cervical disc.
Anterior cervical disc replacements are done through an incision on the front of the neck. The incision length can be as short as an inch and a half but varies based on how many levels are being operated on and the size of your neck.
After making the incision Dr. Paul gently retracts the esophagus, trachea and blood vessels to gain access to the front of your spine. He then removes the disc and removes the disc, or bone. This is done in a manner to relieve pressure on the spinal cord and nerves.
Additional bone and ligament may be released to restore normal height and alignment to the disc space. This is done to improve the long term health of your spine and avoid future surgeries. The disc replacement is then inserted. A plastic surgery closure is used for the skin.
Your disc replacement is MRI compatible, but can create some artifacts on future cervical spine images. It is not known to set off metal detectors.
We have attempted to define the more common risks of surgery under each of the procedures outlined. It is impossible to outline all potential poor outcomes, but we have attempted to do so in good faith. It has not been formed as legal protection for us – only to better inform you. Please read them thoroughly.
Infections are a known complication of lumbar surgery. Infection rates are more associated with smoking, poorly controlled diabetes, obesity as well as other health factors. Less invasive and shorter procedures also have lower complication rates. Infections requiring additional surgery are extremely rare in Dr. Paul’s practice.
Bleeding can be a serious complication since blood accumulation can compress the spinal cord or nerve roots. For that reason we require discontinuing blood thinners, some anti-inflammatories and all herbal medications.
Spinal Leaks are a known complication in spine surgery but typically can be managed. They occur approximately 3 to 5% of the time They can be the result of adherent bone, disc, ligament or scar tissue to the dura and the membrane surrounding your nerves or spinal cord. They are far more associated with revision surgery, severe nerve compression and advanced age. If this occurs, we typically repair the leak during your operation. You may be required to lay flat for a short period of time afterwards. Late presenting or persisting spinal leaks can require additional surgery. Spinal leaks typically do not affect long term outcomes.
The average person should have reasonable functions from day to day. The exception would be people involved with significant overhead activities, such as tradespeople. People with pre-existing stiffness may still have some. Disc replacements do not replicate the natural motion of the spine. If you had neck pain prior to surgery, you may still retain some after surgery. The focus of neck surgery is on neurologic arm symptoms and spinal cord issues.
Because of the risk of bleeding we require you come off the following medications for at least ten days prior to surgery. You may need to get clearance from the prescribing physician to allow a pause in these medications.
Suggestions for choosing your coach..
Be sure to keep the wound dry by changing the dressings at least once a day, more if needed. Your incision may drain for the first week or so after surgery. This is common and expected and should lessen as you get further out from surgery.
Regular dressing changes will prevent problems. A wet dressing will breakdown the healing skin and may lead to delayed healing and possibly infection. You may shower 72 hours after surgery, but you must keep the wound dry. If you cannot keep the wound dry, please take a sponge bath until your first postoperative visit to discuss. Concerning signs include foul smelling drainage and a “tomato red” wound.
Naturally, once anesthetics have worn off, pain will become increasingly evident in the areas involved in a surgical procedure. You may not have much incisional pain after surgery because there is local anesthesia injected at the time of surgery. This will wear off in the evening. We recommend you use the pain medicine prescribed or muscle relaxant to avoid the potential for getting behind your pain.