Cervical Total Disc Replacement (TDR) Surgery
CERVICAL TOTAL DISC REPLACEMENT (TDR) SURGERY
Procedure
Generally, cervical disc replacement is done through a small incision that parallels the skin crease in the neck. It is not much longer than a 1-inch incision, and sometimes even smaller.
Normally, you will feel some soreness in swallowing for a day or two, but the incisional pain quickly gets better because no major structures are cut other than the skin and a very thin muscle underneath the skin.
All the dissection is carried out by following normal tissue plains, in a fashion, we call blunt dissection. It is actually a very pretty operation for a surgeon to carry out because it is basically bloodless and we do not violate or injury the normal tissues.
After surgery, most patients usually experience relief of their arm symptoms and their neck pain as well. However, we know from all the FDA studies that the patients will quickly improve and will continue to do well for as long as we have been following them, and now up to ten years.
Right after surgery, the patient will be placed in a soft collar and then are normally discharged within 23.5 hours, in some cases it may be the same day or may spend the day overnight. Generally, the soft collar is worn to protect the wound.
After the first visit at two weeks, the patient will start some general physical therapy. Because the disc replacement depends on the bone attaching to the prosthesis, the only restrictions we give the patient are to avoid hyperextension or looking up the ceiling and no impact loading such as running for the first 6 to 12 weeks, and certainly, we like the patient to lift no more than 10 pounds for the first 2 weeks.
After the disc is attached to the vertebral body, your doctor may release you to full activities, and in general, we wait for the 3-month mark before we allow people to go back to sporting activities. One can certainly carry on normal activities from the time they leave the hospital to the 3-month mark
Conditions Treated With Cervical Disc Replacement
First, in the cervical spine, it is used to treat herniations that are pinching the nerves, giving the patient neck, shoulder, and arm pain. This is probably the most common problem we see, particularly in younger individuals.
As we get older; however, sometimes bones spurs can pinch the nerve passage and these too, depending on the size of the bone spur, are treatable by disc replacement. The patient may experience in addition pain, numbness, and tingling, as well as weakness in a certain nerve distribution.
What To Expect
Once you have decided to have surgery:
- 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.
- Generally, it is done through a small incision that parallels the skin crease in the neck. It is not much longer than a 1-inch incision, and sometimes even smaller.
- All the dissection is carried out by following normal tissue plains, in a fashion, we call blunt dissection. It is actually a very pretty operation for a surgeon to carry out because it is basically bloodless and we do not violate or injury the normal tissues.
- Right after surgery, the patient will be placed in a soft collar and then are normally discharged within 23.5 hours, in some cases it may be the same day or may spend the day overnight. Generally, the soft collar is worn to protect the wound.
- After the first visit at two weeks, the patient will start some general physical therapy. Because the disc replacement depends on the bone attaching to the prosthesis, the only restrictions we give the patient are to avoid hyperextension or looking up the ceiling and no impact loading such as running for the first 6 to 12 weeks, and certainly, we like the patient to lift no more than 10 pounds for the first 2 weeks.
- Once the disc has attached to the vertebral body, your doctor may release you to full activities. In general, we wait for the 3-month mark before we allow people to go back to sporting activities. One can certainly carry on normal activities from the time they leave the hospital to the 3-month mark.
- After surgery, most patients usually experience relief of their arm symptoms and their neck pain as well. However, we know from all the FDA studies that the patients will quickly improve and will continue to do well for as long as we have been following them, and now up to ten years.