OPTIONS FOR TREATING A HERNIATED DISC
"What Is Cervical Arthroplasty?"
by Dr. J. Alex Sielatycki
Arthroplasty in general is a term we use to describe replacing or reconstructing a joint in the body that has gone bad or is damaged in some way. So classically hip arthroplasty or knee arthroplasty would mean hip replacement or knee replacement.
In the cervical spine (or in the neck), there are joints just like everywhere else in our body. These are made up of the discs in between the vertebrae. So you'll see here these represent vertebrae with the spacers in between the discs.
These are a little bit unlike the other joints and that they don't have a lining. They're not filled with fluid, but they do move and they're designed to do so. So with neck flexion, these compress down with neck extension, they open up and they rotate some as you turn your head left or right.
So disc arthroplasty is a procedure where we can remove a diseased disc and replace it with a device that will preserve motion. Historically and classically, when there was a diseased disc causing severe pain or neurologic deficits, that disc was removed and the space left between the vertebrae was filled with bone graft to do a fusion.
Oftentimes a plate and screws were applied to relieve the symptoms, which can be effective. The problem with that is that when you take away motion between two vertebrae that can impart additional stress to the adjacent vertebrae that now have to make up for that lost motion.
So the idea behind an arthroplasty, as I have here, is that you can remove a diseased disc, remove pressure off the nerves, get rid of a herniated disc or something that's causing severe pain. And then with that empty space in between those vertebrae, we replace that with a motion preservation device.
There are various devices, numerous devices, on the market, and we're not going into that today. But basically, the idea is that it's a device that will still allow the neck to move, flex and extend as it is intended, which can protect some of the other levels from accelerated breakdown down.
It doesn't put additional stress on the adjacent levels. And the studies have shown that it has borne out and that patients who have had disc replacements tend to have a lower risk of needing another surgery down the road for the levels next door or the adjacent levels as compared with fusion.
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Dr. J. Alex Sielatycki
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