WHAT HAPPENS IN DISC REPLACEMENT SURGERY?

Unlike spinal fusions, which fuse two vertebrae together, in a disc replacement, surgeons will remove a diseased, degenerated or damaged disc completely and replace it with a man-made implant which was created to operate just like a natural disc; providing maneuverability and cushioning.

Before explaining how the procedure works, it’s helpful to have an understanding of how discs are supposed to function naturally and why surgery needs to occur at all.

HOW SPINAL DISCS WORK

Your spine is made up of 26 different bones, known as vertebrae which serve as the body’s central support structure and house the spinal cord. If you think of the human body like a tree, the spine would be the trunk.

Now, unlike a tree, our bodies our spines are able to bend, twist and absorb shock thanks, in part, to the thin cartilage inserts that separate each of our vertebrae. These are known as spinal discs.

Spinal discs are primarily made up of two parts:

• The inner part of the disc, known as the nucleus pulposus, which contains a jelly-like material allowing it to flex and absorb shock.

• The outer part of the disc, known as annulus fibrosus, which holds the inner, jelly-like material inside and gives the disc strength.

As a normal part of the aging process, spinal discs start to degenerate. Years of wear and tear can take their toll, causing these discs to flatten out and shrink in size. This is known medically as degenerative disc disease.

In most instances, this degeneration is completely asymptomatic. However, in some instances, the outer part of the disc can grow so weak and flattened that it cracks, allowing the jelly-like substance inside to leak out and press against the sensitive nerve roots that exit the spine. This is known as a herniated disc and is one of the most common reasons for daily neck pain.

This is typically the progression for neck pain that occurs somewhat naturally, but discs can also be damaged by a traumatic accident (like a fall, accident or injury), deformation (like scoliosis), disease or tumors.

In some instances, the disc has become so degenerated that it is beyond repair and needs to be removed in order to help alleviate the neck pain that it’s causing. This is where disc replacement comes in and it typically becomes an option after conservative treatments have been exhausted.

Before recommending a disc replacement surgery, your neurosurgeon needs to look at your specific spine and the vertebrae that make it up to determine whether or not you are a candidate for the surgery. We’ll talk in depth about this process a little further below.

Once you have gone through this process and your spine surgeon recommends you for the surgery, you can undergo the procedure.

Typically, disc replacement surgery takes about 2-3 hours and your neurosurgeon will take what is known as an anterior approach to the spine, which means that he’ll enter through your abdomen or throat in order to access your affected disc.

The reason surgeons often take an anterior approach is because it allows them to work around the spine without having to move any of the sensitive nerve roots that exit from the spinal column. It also allows them to make smaller incisions and induce less muscle trauma which causes the surgery to be safer and allows you to recover more quickly.

Once a neurosurgeon has gained access to the spine, they will typically go about removing the affected disc completely. They will then size the gap between your vertebrae and insert an artificial disk that fits the location perfectly. If necessary, they will drill out certain portions of the vertebrae to make sure the disc is as secure as possible and will not shift during daily wear and tear.