Neck Arthritis (Cervical Spondylosis)

Dr. Justin Bundy and Dr. Ty Carter are our spine specialists at Augusta-Aiken Orthopedic Specialists.  Neck Arthritis, also known as Cervical Spondylosis, is a condition involving changes to the bones, discs, and joints of the neck. These changes can often occur with middle-aged and elderly people, but also can be associated with past trauma. The discs of the cervical spine gradually break down, lose fluid, and become more stiff. As a result of degeneration of discs and cartilage, bone spurs (osteophytes) may form around the vertebrae in the neck. These osteophytes can cause narrowing of the interior spinal column or in the space at each level where spinal nerves exit, causing Cervical Spinal Stenosis. Cervical Spondylosis most often causes neck pain and stiffness. As the stenosis worsens over time, patients may experience weakness in their arms/hands, or change/loss of sensation. Corrective surgery, such as cervical fusion or cervical disc replacement can be very beneficial. Your surgeon will determine which procedure is best indicated for you condition. While cervical fusion is the most common surgical procedure for cervical arthritis, in this article we will highlight the benefits and candidates for the less common, yet very beneficial, cervical disc replacement surgery. 

Benefits of Cervical Disc Replacement

Our spines have discs between each vertebrae, acting as shock absorbers when the spine moves. Over time, these discs can wear down or degenerate, which can narrow the space around the spinal cord and put pressure on the nerves. This may result in pain, numbness, or weakness in the area of the body that the nerve supplies. In the cervical spine (the upper portion of the spine, in the neck), these symptoms often affect one of the arms.

Conservative treatments like physical therapy, anti-inflammatory medications, and steroid injections may be used initially to treat symptoms of cervical disc degeneration. However, if nonsurgical treatments do not relieve symptoms, surgery may be recommended.

Traditionally, cervical disc degeneration has been treated with a spinal fusion, which involves removing the damaged disc material and fusing the two vertebrae together with a bone graft. However, this limits motion in that segment of the spine. With cervical disc replacement, the damaged disc is replaced with an artificial disc. This procedure offers many benefits over a fusion, including:

• Maintained movement in the affected level of the spine
• Lower reoperation rate
• Lower rate of degeneration over time

Candidates for Cervical Disc Replacement

Cervical disc replacement can be very beneficial in the right candidates. Dr. Bundy and Dr. Carter typically offer cervical disc replacement as an alternative to spinal fusion for patients who:

• Are under 55 years old
• Have radicular arm pain (pain that radiates down the arm) caused by a bulging or degenerated disc
• Have no significant neck arthritis
• Have not seen improvement with conservative treatments

Patients who do not meet all of the above criteria are not candidates for cervical disc replacement, and will need to have spinal fusion surgery instead. Additionally, cervical disc replacements are only FDA approved for up to 2 levels of the spine. If a patient has 3 or more bulging or degenerated discs, Dr. Bundy and Dr. Carter will recommend a spinal fusion.

Cervical Disc Replacement Procedure

Dr. Bundy and Dr. Carter perform cervical disc replacements on an outpatient basis, so most patients are able to return home the day of surgery. The procedure typically takes about an hour to complete.

First, the surgeon makes a small incision (typically about 2 inches) at the front of the neck to access the spine. He then removes the damaged disc and replaces it with an artificial disc implant.

Disc replacement implants are typically made up of two metal surfaces, with one being attached to the vertebra above the affected disc space, and the other attached to the vertebra below. A medical-grade plastic insert may be placed between the two metal components, similar to a hip or knee replacement. This technique allows the patient to maintain motion at that level of the spine.

Recovery and Long-Term Results

In the initial recovery period, patients are placed in a soft collar to support the neck and limit motion. Patients typically wear the collar for about 10-14 days. Patients will sometimes have transient swallowing problems during the first 7-14 day after surgery. In these cases, the surgeon recommends a soft diet until these problems have subsided.

Because the surgeon does not have to cut much of the muscle for a cervical disc replacement, patients typically do not experience a significant amount of pain after surgery. Physical therapy is typically not needed.

Once the device has grown into the bone, which can take between 4 weeks and 3 months, patients do not have any long-term restrictions and are able to resume all activities they were doing prior to surgery.

Cervical Disc Replacement in Augusta and Aiken

Our spine specialists, Dr. Justin Bundy and Dr. Ty Carter, have years of experience in treating neck arthritis. In qualified patients, cervical disc replacement can be an excellent, motion-preserving alternative to spinal fusion surgery. If you would like to learn more or schedule an appointment with Dr. Bundy, please call our Augusta office at 706-863-9797 or Dr. Carter, please call our Aiken office at 803-649-2250 or fill out our convenient appointment request form.

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