CERVICAL DISC REPLACEMENT

When Will Neck or Arm Pain Subside After Cervical Disc Replacement Surgery?

Experiencing neck or arm pain can be distressing, especially when you’re eagerly waiting for relief. Post-surgery recovery is highly individual, but understanding the general process can help set realistic expectations.

What to Expect Immediately After Surgery

Most patients wake up from cervical disc replacement surgery with a significant reduction in arm pain. This is often the first and most noticeable improvement. The intense discomfort previously caused by nerve compression tends to diminish swiftly, providing the immediate relief you’ve been longing for.

Neck Pain and Healing Process

While arm pain relief is common right after surgery, some neck pain may linger. This discomfort mainly comes from the surgical incision and is a normal part of the healing process. Hospital staff will typically manage this pain with a combination of oral and intravenous medications, along with antispasmodic treatments, to ensure your comfort during the initial recovery phase.

Long-Term Recovery

For how long have your nerves and spinal cord been under pressure prior to surgery? The answer to this can influence your recovery timeline. If the compression was prolonged, full nerve recovery might take additional time. In some cases, full sensation and strength return gradually over weeks to months.

Steps to Aid Recovery

• Follow Post-Op Instructions: Adhere to all recovery guidelines provided by your healthcare team.
• Physical Therapy: Engage in recommended exercises to enhance flexibility and strength.
• Pain Management: Continue taking prescribed medications as directed to manage any residual pain effectively.

Final Thoughts

Patience and consistent post-operative care are key to recovering successfully from cervical disc replacement surgery. Always consult with your healthcare provider regarding your specific condition and progress for personalized advice.

How To Prepare For Cervical Disc Replacement Surgery

You can always consult with the healthcare provider that guides you through the entire procedure. Below is a list of some steps that you might need to follow:

• Your surgeon must have the information about your medications. Whether it’s herbal supplements or over-the-counter medications, they should know.
• You may be prohibited from the consumption of aspirin or any other medications that leads to thinning of blood or an increase in bleeding.
• If there is any history of reaction to general anesthesia, notify your surgeon about that.
• You should not smoke or drink alcohol before the surgery. The treatment might not be successful.
• The surgeon will probably instruct you on when to eat or drink. However, it’s common to consume nothing after midnight before the procedure.
• Don’t forget to ask your surgeon on the day of the surgery whether you should have your regular medications with little water.

The Procedure Of Cervical Disc Replacement Surgery

Before the beginning of the cervical disc replacement surgery, an intravenous line will be connected to receive the fluids and medications. This procedure makes you feel relaxed and sleepy and is performed under general anesthesia.

Your anesthesiologist will discuss the specifics of the anesthesia plan with you, including what medications will be administered to ensure you remain pain-free and comfortable. General anesthesia means you will be asleep and unaware during the procedure, ensuring no pain is felt during the surgery itself.

• Pain Management: Although you may experience some discomfort upon waking, this will be effectively managed with both intravenous and oral pain medications.

The surgeon will provide the medication through the IV so you can sleep and insert a protective tube in your throat for breathing. Once you are fully asleep and the breathing tube is in place, you’ll be carefully positioned on the operating table.

• Surgical Preparation: Rest assured, surgery will only commence after you are asleep and adequate pain medications have been administered, ensuring your comfort throughout the procedure.

The Process

The surgery or the actual procedure can last a few hours or two. And, once the procedure begins, the following will take place:

• To check your pulse rate, heart, blood, and oxygen level, the surgeons will place monitors and advanced equipment.
• The area of your neck will be cleaned to kill germs and bacteria on your skin with a special solution.
• The surgeon will cut a one-to-two-inch incision either on the front or on the side of your neck.
• Then, the surgeon will carefully move the vital structures of the neck until the revelation of the bones of the cervical disc.
• The surgeon will remove the replaced cervical disc.
• The empty disc space gets secured with an artificial disc.
• By using absorbable sutures, your surgeon will close the incision under the skin. Then to minimize any scarring, the skin is carefully closed with sutures.
• After the application of a small dressing over the incision, you may have to wear a soft collar on your neck for protection. It restricts motion.

Some steps might be different from those mentioned above. Therefore, you must consult everything with your healthcare provider about the procedure during your surgery.

What is the Procedure for Decompression in Cervical Disc Replacement Surgery?

Cervical disc replacement surgery is a meticulous procedure that involves several critical steps to ensure the spinal cord and nerves are free from compression. Here’s a breakdown of the process:

• Verification of Surgical Site: Before addressing the issue, the surgeon confirms the exact location of the problem disc using an X-ray. This verification happens while the patient is anesthetized to ensure precision.
• Decompression Process: Once the correct level is pinpointed, the surgeon embarks on the decompression phase. This involves carefully eliminating the sections causing pressure on the spinal cord.
• Disc Removal: Specialized instruments come into play as the surgeon extracts the disc that’s impinging on the spinal cord or nerves.
• Clearing Additional Impediments: Post disc removal, the surgeon checks for other structures like bone spurs or thick ligaments that might also exert pressure. These are meticulously removed to prevent any remaining compression.
• Final Check for Compression: After removing all impediments, the surgeon performs a thorough assessment to ensure the spinal cord and nerves are entirely relieved of any compression.

This step-by-step approach ensures that the cervical spine is properly decompressed, paving the way for successful disc replacement and alleviating symptoms caused by nerve compression.

Advantages of Cervical Disc Replacement

In cervical disc replacement surgery, the surgeons will replace the diseased cervical disc with an artificial one. When this procedure was not available, the doctors used to remove the affected area. Then to prevent the motion, the above and below vertebrates were fused.

The replacement of new discs with natural cervical discs is a new type of FDA-approved treatment. This surgery provides more movement and creates less stress on the other remaining vertebrates.

But, before you want to have cervical artificial disc replacement (ADR) surgery, it is crucial to know what it wants to accomplish. The benefits of cervical ADR include:

• Disc replacement improves locomotor function

The cervical disc replacement helps with normal neck motion. It means the patients get to move their heads and neck without any pain. This increase in movement progresses day-to-day function and offers a better quality of life.

• Cervical ADR reduces stress on the spine 

The adjacent vertebrae experience further degeneration due to the extra stress and loss of motion. Undoubtedly, disc replacement surgery minimizes the increased stress, maintains motion, and protects the adjacent vertebrae.

• Surgery offers a faster recovery

Other than traditional fusion surgery, recovery from cervical ADR is much faster. You can get to work or your normal schedule within four days of the surgery. Besides, you don’t need to worry about the complexities of fusion surgery.

Risks Associated With Cervical Disc Replacement Surgery

Without a doubt, every surgery has some risk, so choosing a relatively safe procedure like disc replacement surgery is better. Cervical disc replacement is a new method of surgery with little information to follow. That’s why the risk still prevails. Discuss the risks and benefits of the surgery with your surgeon thoroughly.

Some of the potential risks of cervical ADR are:

• You may experience bleeding, infection, nerve injury, spinal fluid leak, voice change, or stroke.
• The difficulty of breathing and swallowing any food cannot be ignored.

During surgery, small nerves that control your larynx (voice box) are in close proximity to the surgical site. These nerves are crucial for maintaining normal speech and swallowing functions. If they become irritated or injured, you might experience a hoarse voice, which could persist for weeks to months as the nerve recovers.

Additionally, some patients report a sore throat after surgery. This discomfort may stem from the endotracheal (breathing) tube used during the procedure or from the retraction of the esophagus and windpipe. Fortunately, this soreness typically improves shortly after the surgery.

Understanding nerve-related complications can help set realistic expectations and prepare you for the recovery process.

When it comes to infection, the risk is very low, sitting at less than 1%. However, certain conditions might increase this risk. If you are overweight, immunosuppressed, on chronic steroids, or diabetic, your likelihood of infection may be higher.

To mitigate these risks, antibiotics are administered before surgery begins and are continued for 24 hours afterward while you remain in the hospital. This proactive approach helps decrease the chance of infection, providing an added layer of safety during your recovery.

While bleeding is a potential risk, it’s generally considered very low. However, the risk may increase if you’re taking blood thinners, fish oil, or herbal medications, or if you have a clotting disorder. To minimize this risk, it’s essential to stop these medications before surgery as advised by your healthcare provider.

During surgery, a special tube called a drain might be used to collect any blood or fluids that accumulate post-operatively. This drain is typically removed before you leave the hospital, usually the day after surgery, ensuring that any excess fluids are effectively managed.

By understanding nuances, patients can take necessary precautions to reduce the likelihood of complications.

• The difficulty of breathing and swallowing any food cannot be ignored.
• If the surgery is not successful, the chances of having a broken or loosened artificial disc are high. Here you may need to go for another surgery.

Nerve Damage

• Small nerves controlling your larynx are near the surgical site. If irritated, you might experience a hoarse voice post-surgery, which usually improves over time.
• Some patients report a sore throat due to the breathing tube or retraction of the esophagus during the procedure, but this typically subsides.

Dural Tear and its Management during Surgery

• A dural tear refers to a small rip in the dura mater, which is the tough outer membrane surrounding the spinal cord. This can occasionally happen during spinal surgery, especially if the dura is thin or particularly fragile in some patients.

How Is a Dural Tear Managed?

• Immediate Repair: If a dural tear occurs, the surgical team swiftly aims to repair it. This involves suturing the tear to restore the integrity of the protective layer.
• Postoperative Care: After repairing a dural tear, it may be necessary for the patient to maintain a specific position, such as sitting upright, for up to 24 hours. This positioning helps ensure the repair remains secure and promotes optimal healing.
• Outcomes: The good news is that studies indicate a repaired dural tear typically does not negatively impact the overall outcome of the surgery. Patients generally recover well after the repair.

While dural tears are not common complications, understanding their management can provide reassurance about the recovery process and success of the surgical procedure.

Infection

• The risk of infection is very low (<1%), but increases if you’re overweight or have conditions like diabetes. Antibiotics are administered before and after surgery to minimize this risk.

Bleeding

• While bleeding risk is low, it increases with the use of blood thinners or herbal medications. These need to be stopped before surgery.
• A drain might be placed during surgery to collect excess blood or fluids and is usually removed the next day.

Spinal Cord or Nerve Damage

• This risk is minimal, thanks to a neuromonitoring technician who will oversee nerve and spinal cord function throughout the procedure.
• You’ll meet the technician before surgery to discuss their role, and small wires will be placed on your limbs to monitor nerve activity.

Understanding these potential complications and preventive measures can help you prepare for the surgery and recovery process, ensuring you have a comprehensive view of what to expect. To address these risks, a specialized team is on hand during your surgery. This includes a neuromonitoring technician, who is trained to monitor your nerves and spinal cord throughout the procedure. Their role is crucial in minimizing the risk of nerve damage, as they work alongside a neurologist to ensure your safety.

Before the surgery, you’ll have the opportunity to meet with the neuromonitoring technician. This meeting allows you to ask any questions about their role in your care, providing reassurance and transparency. Once you are under anesthesia, the technician will place small wires on your legs and arms. These wires allow for real-time monitoring of your nerve and spinal cord function during the surgery, acting as an additional safeguard against complications.

By having a dedicated team focusing on nerve and spinal cord health, the overall risk of damage during cervical disc replacement surgery remains very low, providing you with peace of mind as you undergo the procedure. However, depending on your medical conditions, chances of other risks are also there. Therefore, consult with the surgeon as early as possible.

What is the Risk of Inadequate Relief of Symptoms After Surgery?

Experiencing inadequate symptom relief post-surgery can be a concern for many patients. Here’s a breakdown of what might contribute to this risk and how it can be addressed:

• Targeting the Correct Spinal Level: One crucial factor is identifying the precise spinal level causing the symptoms. Misidentifying this area can lead to ineffective surgery. Ensuring this involves careful diagnosis and planning.
• Multiple Degenerated Levels: Sometimes, multiple areas in the spine are degenerated but not all of them require surgical intervention. If surgery only addresses some worn-out levels, the untreated areas may continue to cause discomfort.
• Wrong Level Surgery: Performing surgery at an incorrect spinal level is another risk. Accurate pre-surgical planning and diagnostics are essential to avoid such scenarios.
• Severe or Irreversible Conditions: In cases where the spinal cord compression is too advanced or severe, surgery may not fully alleviate the symptoms. Such conditions might render certain damages irreversible, limiting the success of surgical intervention.
• Role of Spinal Injections: Spinal injections given during the conservative treatment phase can help predict surgical outcomes. These injections are not only diagnostic but also confirm which specific spinal level is causing the issues. This precision enhances the chances of a successful surgery.

Understanding these factors can help patients make informed decisions and work closely with their healthcare provider to improve surgical outcomes.

What To Expect After Cervical Disc Replacement Surgery?

You will stay under observation in the recovery area until the faded effect of anesthesia. Experiencing pain after the disc replacement surgery is normal. So, pain medication is essential for consumption. Some people may have to stay more days in the hospital. And, this is what you can expect during your hospital stay:

• The continuation of intravenous fluids until you get to drink the fluids properly by mouth.
• You can start having your regular normal diet, once you start drinking normally.
• If the pain doesn’t go away, the doctors will suggest you continue the pain medication.
• The nurses will keep on checking your medical dressing.
• You may have to wear a support collar in the hospital.
• Once you have started to feel better, the doctors and nurses will encourage you to get out of bed and do little movements.

If the doctors think you are ready to go home, you will get discharged. 

• Even at home, wearing soft or rigid neck support is necessary.
• Now you can follow your normal diet.
• After removing the sutures, you may have to return to your surgeon for further checkup.
• Slowly you will start returning to normal activities.
• After a few weeks, you can continue physical therapy.

However, you should contact your surgeon if you suffer from these issues:

• Fever, headache, bleeding, redness, swelling, or discharge from the stitch
• Terrible pain even after having pain medication
• Numbness or weakness
• Difficulty in swallowing regular food or water
• Change in voice or hoarseness
• Difficulty breathing or speaking

Conclusion

If the pain is chronic and it’s affecting your regular life, a cervical disc replacement can help. Our healthcare team at the Southwest Scoliosis and Spine Institute with offices in Dallas, Plano, and Frisco, Texas will guide you through the whole procedure. If you or your child has neck pain and want to further discuss the options to avoid and stop the pain, we invite you to give us a call and make an appointment to speak to one of our Spine Doctors. Our Medical Practice has top-rated specialists with the experience and knowledge necessary to offer patients the best possible treatment for neck pain. Additionally, we welcome new patients and urge you to make an appointment.

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National Institute of Health: Cervical Disc Replacement