For patients with radiculopathy or myelopathy related to single-level disc herniation in the cervical spine, most spine surgeons remove the intervertebral disc and perform interbody fusion. Yet today, fusion may not always be ideal for preserving patients’ motion or minimizing their risk of future adjacent-level disease and future fusion surgery. For these, surgical removal of the disc and implantation of an artificial disc — called “cervical spinal arthroplasty” — may be more appropriate.
The benefits of artificial disc replacement.
Compared to cervical fusion, artificial disc replacement’s primary benefit is preservation of motion. Cervical arthroplasty may also help prevent adjacent-level disc disease in the future, which can occur with interbody fusion. (And it may lead to a faster return to normal activities.) Since younger patients have more time to develop adjacent-level disease, and because normal motion is a more important consideration for them than for older patients, young, active patients should be considered as potential candidates for disc replacement.
How cervical arthroplasty is performed.
Cervical disc replacement begins with an anterior approach. The trachea and esophagus are retracted, the cervical spine is exposed, the proper level is identified and the disc is removed, thereby decompressing the nerve. Measurements are taken and the artificial disc is assembled. The disc, which consists of upper and lower parts that slide and pivot to mimic natural movement, is then placed into the disc space and is attached to the upper and lower vertebral bodies.
Give your patients complete options for cervical radiculopathy/myelopathy.
Comprehensive Neurosurgery’s E. Thomas Cullom, MD, is one of Mississippi’s only physicians trained in this procedure. Its technical challenges and low reimbursement compared to fusion may contribute to this reality. A well-trained, highly experienced neurosurgeon, Dr. Cullom not only possesses the capability and competence needed for this surgery, he also believes it is the most appropriate, effective treatment for certain patients.
Artificial disc replacement is not indicated for patients with existing arthritic change, reduced motion at the pathologic level, infection, segmental instability, osteopenia/osteoporosis, rapid joint disease, bone friability or calcification problems or metabolic bone disease.
For more information about cervical arthroplasty or spine pain, don’t hesitate to call. We welcome and encourage your inquiries and referrals. Call Comprehensive Neurosurgery in Flowood at 601-664-1000. We are conveniently located just outside of Jackson and Forest, Mississippi.