Why Is It Done?

Nerve root compression can be caused by a disc herniation, degenerative loss of disc height, or from bone spurs. Any of these conditions can narrow or obstruct nerve pathways. Traditional surgery alleviates nerve compression by removing the diseased disc, restoring lost disc space between the upper and lower vertebrae, and fusing the vertebrae together. Although the procedure helps to alleviate the patient's symptoms, after the neck heals and fuses, the motion in the vertebral segment is lost. The beauty of an artificial disc is it is designed to preserve motion at the vertebral segment and may lessen stress to adjacent spinal levels.

Traditionally, the surgical procedure performed is called an anterior cervical discectomy and fusion. This means the surgical incision or approach, is made at the front of the neck (anterior) and the diseased or damaged disc is removed (discectomy). The empty disc space is filled with the patient's own bone (called autograft) or other graft product to induce new bone to grow between the vertebrae. A cervical plate and screws are implanted to provide immediate spinal stability. Over time, the bone graft does its job to cement, or permanently fuse that particular spinal segment into one piece. Basically, the same procedure is used to implant a cervical artificial disc, except the need for fusion is eliminated.

What are the advantages to artificial cervical disc surgery?

One immediate advantage to using an artificial disc is that one does not have to wait for fusion to occur. Post-operative recovery is shortened and patients may or may not be placed in a soft collar. Patients can return to near normal activities - except of course, vigorous athletic activities until the wound has satisfactorily healed and the artificial disc is firmly attached to bone.

The need for internal fixation such as a cervical plate and screws is eliminated and only the intervertebral space is affected. If a plate and screws are used in a fusion procedure, there is the possibility that the levels above and below the fusion will be affected.

The added advantage to an artificial disc is that is maintains motion and lessens the chance of transition syndrome, which can be a real problem in traditional spinal fusion. Transition syndrome means a segment of the spine adjacent to the fused segment degenerates or breaks down, which can affect disc height and spinal stability.

Since bone grafts are not needed, the patient is spared a surgical procedure where their own bone is harvested from their hip (iliac crest), which can be painful post-operatively.

PRESTIGE® LP Cervical Artificial Disc System

The PRESTIGE® LP Cervical Disc System is a titanium ceramic composite device with two articulating components (ball on top & trough on the bottom) that are attached to the vertebral bodies. This unique ball and trough design provides for replication of normal physiological motion. Dual stabilization rails and a plasma spray coating on each component help encourage bony in-growth and long-term stability. The PRESTIGE® LP Disc is available in a variety of sizes to allow the surgeon to closely match the patient's anatomy.

The Operation

The surgery is designed to replace a damaged or diseased disc in your neck with the implant. The disc is first removed through a small incision made in the front of the neck. In its place, Mr. D'Urso will then prepare a space with specialised tools and then insert the artificial disc. The procedure should relieve the symptoms of nerve root or spinal cord compression caused by the damaged disc. The surgery should allow for motion at the operated disc level, unlike a fusion surgery.

What Happens Afterwards?

Mr. D'Urso will advise you about your specific recovery plan following surgery. It is important to follow these instructions carefully to recover from surgery as quickly as possible and increase your chances of a successful outcome.

After surgery Mr. D'Urso may refer you to a physiotherapist who will teach you exercises to improve your strength and increase your mobility. The goal of physiotherapy is to help you become active as soon as possible, using safe body movements that protect your neck.

Recovering from pain and surgery is an ongoing process. How fast you recover depends on your commitment to working closely with your physiotherapist, and moving and exercising correctly, as recommended by Mr. D'Urso.

Mr. D'Urso will continue to work with you during your recovery. Before you leave hospital, Mr. D'Urso may schedule followup visits with you so he can evaluate your progress, advise you about your activity level, and adjust any medication, if necessary. Sometimes your doctor may recommend follow-up tests to make sure you are healing properly.