A cervical disc is the cushion between the vertebrae that make up the spine. They also allow for motion between those vertebrae so a person’s neck can move. But sometimes issues with cervical discs can arise, and you may need the help of a spine specialist.
Cervical disc problems
One of the most common causes of cervical disc issues that may require surgery is the presence of disc material pushing onto the spinal cord or nerves at the end of the spinal canal. This can cause a variety of symptoms.
“Compression of the nerve root can cause pain, numbness, tingling and weakness in the arm,” said Dr. Jason Potocki, Marshfield Clinic Health System orthopedic spine surgeon. “Compression of the spinal cord can cause loss of balance, pain or numbness in the hands and loss of fine motor coordination. Oftentimes, if someone’s spinal cord is compressed, they can have a combination of all those symptoms.”
Patients usually try physical therapy, chiropractic care, anti-inflammatory medications or epidural steroid injections to relieve the symptoms before considering surgery.
More than just one surgical option
Traditionally, if someone needed surgery for cervical disc issues, they’d have an anterior cervical discectomy and fusion. In recent years, anterior cervical disc replacements have become a new option. Disc replacements involve newer technology that continues to evolve. But the two procedures are similar in several ways.
“We start with an incision on the front of the neck and remove a problematic cervical disc from in between two vertebrae, working front to back,” Dr. Potocki said. “This allows for any disc material to be safely removed from the front of the spinal cord and/or nerve roots to relieve the pressure.”
For cervical fusions, bone graft is then placed in between the vertebrae and the area where the disc used to be. It is secured with a plate and screws. Over time, the two vertebrae will form one solid bone.
For cervical disc replacements, a device is inserted that allows for more motion between the vertebrae. It is a similar concept to replacing a hip or knee joint.
Pros and cons
Dr. Potocki says cervical disc fusions have a long track record with proven results. However, recovery takes several months while the bone grows together and activity must be limited. Another downside is a loss of motion between the two affected vertebrae. That increases pressure on the discs above and below, which can cause problems for the patient in the future.
Cervical disc replacements have fast recovery times. Patients can usually resume full activity within a few weeks. Furthermore, there is no loss of range of motion in the surgical area. The main risk is chronic neck pain.
“If someone’s neck is arthritic, replacing the disc can actually increase neck pain,” said Dr. Potocki. “That’s why replacements are often reserved for patients under the age of 40 who have no indication of arthritis or other problems with the disk.”