A cervical disc replacement is a cervical disc operation where a mobile prosthesis is inserted instead of performing a fusion with a cage

Why is a cervical disc replacement recommended?

The operation is performed to remove a disc prolapse that is causing neck pain as well as arm pain and/or spinal cord symptoms.
Disc prolapses can resolve spontaneously so surgery is usually indicated after non-operative treatment has failed to result in improvement. Non-operative treatment will include pain relief, physiotherapy and sometimes a cervical epidural injection of steroid.

A disc replacement is an alternative to a fusion operation (ACDF). Generally younger patients with an acute cervical disc prolapse may be suitable for a disc replacement procedure. Rather than a cage, a mobile disc prosthesis is inserted into the disc space. The operation is otherwise the same as an ACDF.

Cervical disc replacement is potentially associated with a lower rate of disc problems at other levels in the future compared to fusion.

How is surgery performed?

Under general anaesthetic, a small incision is made in the front of the neck along a natural skin crease. An anterior approach is relatively pain-free, as it does not involve significant trauma to muscles, and it allows the surgeon to safely access a cervical disc. 

Once your surgeon has ascertained the correct disc level with an x-ray, a microsurgery technique is used to remove the relevant disc. This results in decompression of the affected nerve root and/or spinal cord.

After nerve decompression a mobile disc prosthesis is inserted into the disc space using x-ray control. Precise positioning is important. The commonly used types of prosthesis used at The Brain & Spine Clinic are the Mobi-C and M6C disc replacements.

What happens after surgery?

Post-operatively, you will be able to mobilise a few hours following surgery. A wound drain is removed by nursing staff the following morning and you will be reviewed by your physiotherapist. It is recommended that you do not drive a car for two weeks and that you do not work full-time for four to six weeks. The most important message following a cervical disc replacement is to avoid lifting any significant weights for the first few weeks following surgery. It is normally recommended that you have 4-6 weeks off work after cervical disc surgery.

If you have any questions about your post-operative care, then your surgeon will be happy to speak to you directly.

How successful is the operation?

Patient satisfaction rates are 85-90% and we would expect 90% of patients to experience significant relief of arm pain. Pain relief is normally immediate. If numbness or weakness are present before the operation, then these may recover over a time period of months.

What are the risks of surgery?

There is a small risk of wound infection (1%), bleeding (1%) or spinal fluid leak (1%). You will likely experience some swallowing discomfort in the early post-operative period. Occasionally this may persist longer. 2-3% of patients may experience transient hoarseness of voice and rarely this can be permanent. 

There is a small risk of implant-related problems requiring revision (1%).

Neurological injury to a spinal nerve or spinal cord is rare, but can result in serious problems such as numbness, weakness or paralysis in the limbs or problems with bladder, bowel or sexual dysfunction.

If your risk of worsening of spinal cord function is felt to be higher than normal (for example, if you have severe spinal cord compression) then your surgeon may discuss with you the use of intra-operative spinal cord monitoring.

There is a small risk associated with general anaesthesia (heart problems, chest complications, blood clots, infection) and these risks may increase with certain medical conditions.