Arthroscopy is an attractive surgical option for many patients as it can help to restore spinal stability while maintaining the range of motion of the spine. This alternative to spinal fusion is especially popular with younger patients with many active years ahead of them, as well as with patients who have neck or back pain related to a single level disc herniation or herniation of just two discs.
The discs in the spine serve as shock absorbers and help maintain the intervertebral height and spinal structure. When these discs are damaged, through trauma, wear and tear or illness, they may herniate or bulge, putting pressure on nearby nerves and even the spinal cord itself.
Spinal discs can take a long time to heal if they heal at all. This is partly because they have no direct circulation, meaning that they easily become dehydrated and brittle and have no direct supply of nutrients to facilitate repair.
Traditionally, damaged spinal discs that are symptomatic are removed and the patient undergoes spinal fusion to stabilize the spine by filling the disc space with bone graft material. By fusing two or more vertebral levels together, this prevents undesirable movement in the spine. However, fusion also prevents the normal, healthy movement of the spine facilitated by healthy discs. Fusing two or more sections of the spine together can also accelerate damage in the vertebrae above and below the site of fusion.
Surgeons are now able to use artificial discs to replace worn-out discs in the lumbar spine and cervical spine, giving patients an opportunity to restore stability while preserving the flexibility of the spine. Arthroscopy is typically performed through the front of the spine, allowing the surgeon to visualize the spinal structures, remove damaged disc material, and correctly position the prosthesis (the artificial disc) between the vertebra.
A number of artificial discs are currently being used in Europe and are at various approval stages with the US Food and Drug Administration, meaning that options are continually increasing for patients in need of disc replacement surgery. Discs are made of metal and very hard plastic and are attached to the upper and lower side of the adjacent vertebra so the implants are able to slide against each other smoothly to mimic the normal motion of the intervertebral discs.
Arthroscopy is an attractive surgical choice for many patients but may not be suitable for people with osteoporosis or severe arthritis. The usual risks of surgery apply, but complications are rare. Results so far show that disc replacement has equivalent or superior results when compared to standard discectomy and fusion. Recovery after disc replacement is typically much shorter than with discectomy and spinal fusion and eliminates the risk of pseudoarthrosis (or non-fusion).
For patients undergoing cervical disc replacement, cervical collar immobilization is typically limited to a week or less. For spinal fusion, immobilization may be recommended for 4-6 weeks. Symptoms of nerve impingement, such as pain and altered sensation, may resolve immediately or relatively quickly after arthroscopy as the surgery removes herniated disc material and other causes of nerve compression.
To see if disc replacement surgery is a good choice for you, contact us today and discuss your options with a qualified spine surgeon.