Cervical Total Disc Replacement (TDR)

Description of Total Disc Replacement

As spinal structures degenerate, they may cause back pain or neck pain, limiting function and decreasing quality of life. Total disc replacement (TDR, also called artificial disc) surgery is one of the latest advancements in spine surgery. Replacing the disc removes the cause of pain while preserving natural motion. Total disc replacement is recommended only after extensive conservative therapies have failed to significantly provide pain relief. The surgeon makes an incision in the front of the neck. The contents of the neck are gently retracted, enabling the front part of the spine to be seen. Fluoroscopy is used to determine the correct level(s) before the disc material is removed and the artificial disc is inserted.

Conditions Treated with Total Disc Replacement

Cervical Total Disc Replacement (TDR) is performed for the treatment of herniated disc, painful disc degeneration, radicular syndrome and other cervical spine problems.

What to Expect Before the Total Disc Replacement Procedure

Once you have decided to have surgery, the following events take place:

  • A medical examination.
  • Chest X-ray, EKG and blood work.
  • You may be asked to have a neurological or psychological examination.
  • If taking aspirin or anti-inflammatory medications daily, stop these medications at least one week before surgery.
  • If you take prescription medications or other drugs, including herbals, ask your doctor how soon before surgery you should stop taking these.
  • Do not have anything to eat or drink for 6 to 8 hours before surgery.
  • You will check into the hospital the morning of surgery.
  • Prior to surgery, you will be asked to sign permits for surgery, anesthesia, blood and blood products.

What to Expect During the Total Disc Replacement Procedure

  • The surgeon makes an incision in the front part of the neck.
  • Fluoroscopy (live X-ray) is used to determine the correct level(s) to be operated.
  • The contents of the neck are gently retracted to the side so that the spine can be seen.
  • Disc tissue is removed.
  • A disc replacement is placed in the disc space.
  • Surgery takes approximately 1-2 hours.

After the Procedure

  • You will be in the recovery room from 1 to 1½ hours.
  • The surgeon will contact your family while you are in recovery.
  • After going to a hospital room, you will be able to use a PCA pump to get medication for pain control. This machine controls the amount of medication that can be received.
  • Staff will usually get you out of bed shortly after surgery.
  • The hospital stay is usually 1-2 days.
  • A brace or collar may be prescribed to restrict bending for several weeks.
  • You will be given any needed prescriptions and discharge instructions.
  • A set of exercises that you can do at home will be provided.
  • You will be able to ride in a car or plane upon leaving the hospital.
  • Physical therapy is usually initiated after the first office visit with your doctor following surgery.

Recovery from cervical total disc replacement (TDR) varies greatly among patients and is dependent on the extent of the surgery as well as the age and health of the individual. Return to work also varies greatly among patients and is related to overall health and the type of work you do.

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