Maintain neck motion with new artificial disk surgery

Neck pain is a common problem, affecting many adults at some time in their lives. It can make driving a vehicle, computer work and hobbies painful or even impossible. The pain may involve just the neck and shoulders, or it may radiate down an arm. The pain can be dull or feel like an electric shock into your arm.

Cervical disk replacement is a new surgical procedure that can relieve pain while preserving the neck's range of motion. Here's what you need to know.

Causes of neck pain

Your spine is a stacked column of two components: vertebrae and disks. Vertebrae are the bones in the spine, and disks are rubbery cushions that sit between the vertebrae.

The disks act as shock absorbers, allowing your spine and neck to bend, flex and rotate. The neck consists of seven vertebrae, called cervical vertebrae, and corresponding disks.

For some people, muscle strain causes neck pain. This could be a result of poor posture, carrying a heavy backpack or purse, cradling your phone between your shoulder and neck, or sleeping with too few or too many pillows.

Neck pain also could be caused by structural changes to the cervical vertebrae or disks, including:

• Cervical spondylosis
  This is a general term used to describe age-related wear and tear affecting the spinal disks. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones, also called bone spurs.
• Spinal stenosis
  This condition occurs when the spaces in the spine narrow and put pressure on the nerves that travel through the spine.
• Herniated disk
  This occurs when a tear in the tough outer layer of the disc allows some of the inner disk material to expand outward. Herniated disks also are called ruptured disks, although the whole disk does not rupture or slip.

Often, neck pain responds to nonsurgical treatment, such as rest, steroid injection, stretching and massage. Surgery may be needed if pain continues, leads to neurological changes like weakness or numbness, or is accompanied by a structural issue.

Types of cervical surgery

In the past, the most common types of surgery on the cervical disks were spinal fusion and decompression surgery. During a spinal fusion, a spacer graft material is placed two or more cervical vertebrae. Eventually, the vertebrae grow together, or fuse, over time.

Spinal fusion and decompression surgeries are often performed together. While these procedures are safe and relieve the pain, they permanently immobilize the spine and change the way the neck moves. Patients may no longer be able to turn their neck fully or look over their shoulders.

In addition, fusion can place additional stress and strain on the vertebrae above and below the fused portion. This could increase the rate of degeneration in those areas of your spine. This is called adjacent segment disease.

Cervical disk replacement

The Food and Drug Administration recently approved cervical disk replacement surgery as an alternative to spinal fusion. Like a knee replacement surgery, the artificial disk allows for full or nearly full range of motion after the surgery.

During a cervical disk replacement, your surgeon makes a small incision on the side or front of your neck. After other structures are moved to the side, your surgeon can access your spine. The worn-out disk is carefully removed and replaced with an artificial disk between two vertebrae. The artificial disk has two metal plates that are anchored to the roof and floor of the disk space to keep it in place.

Replacing a disk in your cervical spine may help relieve pain in your arms while maintaining motion and flexibility in your neck. It also decreases the stress on your remaining vertebrae.

If you have facet joint disease or syndrome, you cannot have disk replacement surgery.

Cervical disk replacement recovery

If you have a cervical disk replacement, you can expect to remain in the hospital one night. You'll be encouraged to begin walking the day after surgery.

Physical therapy will begin about six weeks after surgery. You also will have lifting and driving restrictions immediately after the procedure. It is important not to attempt to rush your recovery, as your vertebrae and artificial disk need time to heal.

If you experience neck pain, talk with your health care professional or neurosurgeon about treatment options that can make a difference.

Navid Khezri, M.D., is a neurosurgeon in La Crosse, Wisconsin.