Cervical Artificial Disc Replacement
Damaged discs in the cervical spine may cause neck pain, which could radiate across the shoulders and down to the area between the shoulder blades. Headaches are often experienced, too.
The Operation
How long does the surgery take?
The operation normally takes about two hours for a single level disc replacement and about three and a half hours if two discs are being replaced.
Where is the incision made?
Contrary to expectation, the incision is made to the front of the body (with the patient lying on their back), usually on the right hand side. The incision is about 4 cm long for a single level, slightly longer for a two level, and follows the direction of the neck's natural skin creases. Its precise position will depend on the level of the disc being replaced.
What happens during the procedure?
After making the incision, access to the cervical spine is between the large blood vessels (the carotid artery and jugular vein, which are easily felt in the neck) on one side and the trachea and pharynx towards the midline. The pharynx is moved over to the left to show the front of the spine and then a marker is placed on the disc and an X-ray obtained to confirm the level where the surgery is required.
The damaged disc is completely removed, with particular care taken to extract any material which has protruded backwards to press on the nearby nerve root. There may also be some bony spurs causing similar problems and these are also removed. By thoroughly clearing away all the narrow and worn disc material the normal disc height can usually be restored. To help with this, small pins are inserted into the vertebrae above and below the disc, and a special frame is used to open up the disc.
Trial implants are then used to establish the correct size of the implant and to ensure that it is placed in exactly the right position. This is very important and X-ray guidance is used to ensure a perfect position is achieved.
A special cutter is then used to create slots for the keel ridges of the implant itself. The trial is then removed and the cervical artificial disc replacement is inserted, using the keel cuts like guide rails to ensure it is properly positioned. Placement is meticulously checked, millimetre by millimetre, as the disc replacement is inserted.
The following short animation illustrates the surgical technique.
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In memory of Nick Boeree
Following the sudden death of Nick Boeree we have set up a tribute page to allow you to share your memories, thoughts, and feelings. Click here.
My experience at The Spine Clinic could not have been better. Nick and the entire staff were extremely competent and professional and everything was done to make me as comfortable as possible for the surgery. Most importantly, it was a great success.
Tyler Dylan-Hyde
