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HomeSummaryReview of the conditionConsidering surgeryPreparing for surgeryAbout the procedureTechnical details Anesthetic Length of cervical disc replacement vs. cervical fusion Recovering from surgeryRehabilitationConclusion

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Cervical Disc Replacement or Fusion? Surgery for arm and neck pain, numbness, tingling and weakness from neck arthritis, disc herniation (slipped disc) and radiculopathy

Last updated Tuesday, June 09, 2009

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About the procedure

Technical details

Exposure
The exposure for total disc replacement and anterior cervical discectomy and fusion is the same.

After the anesthesia is administered and the patient is given prophylactic antibiotic, a horizontal incision (3 cm to 4 cm) is made on the front of the neck. This incision is made in line with the way the skin runs, so it can heal along skin lines with minimal scarring.

Dissection through superficial muscle layers, around the midline esophagus and airway structures, and onto the cervical spine is then performed. Retractors are placed. An intra-operative X-ray is performed to confirm the appropriate level of surgery.

The intervertebral disc is then completely removed. Foraminotomies can also be performed. A foraminotomy is the direct decompression of the space through which the nerve root travels. Disc material or bone spurs can impinge in this area, and place pressure on the nerve root. (Figure 5)

Total Disc replacement
After removal of the disc, the disc replacement implant is inserted. X-rays during the surgery are used to ensure the appropriate position of the implant. (Figures 2 & 3)

Fusion
After adequate decompression of the spinal cord and or nerve roots, a bone graft is then impacted into place where the disc was removed, between the two vertebrae.

A small titanium plate is then placed on top of the bone graft and into the bone above and below Screws are placed into the bone above and below to hold the plate in place. This plate gives additional stability to the structure. (Figure 1)

Closure
The surgical wound is then washed out, and the layers are closed with suture. The skin is closed with an absorbable suture, and there is no need for suture or staple removal. A drain is placed for 24 hours and is removed the next day.

Anesthetic

General anesthesia is necessary to perform this procedure. For spine procedures, it is generally advisable to have the patient go to sleep for their anesthesia than to be partially awake. With such meticulous dissection around the spinal cord and nerve tissue, sudden inadvertent patient motion may result in injury.

Length of cervical disc replacement vs. cervical fusion

In general, the procedure takes 45 to 90 minutes.

Surgery for Cervical Radiculopathy at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington

If you are interested in making an appointment to discuss this procedure in Seattle, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 to make an appointment. Our clinical center is located in Seattle Washington, USA

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