Total Cervical Disc Replacement cost in India

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What is total Cervical Disc replacement-Spine?

Cervical disc replacement surgery involves removing a diseased cervical disc and replacing it with an artificial disc. Before this procedure was available, the affected disc was removed and the vertebrae above and below were fused together to prevent motion.

Why it is needed?

Our cervical spine is made up of the 7 bones, called cervical vertebrae, stacked on top of each other forming the neck area. The cervical disks are the cushions that lie between the cervical vertebrae. They act as shock absorbers to allow your neck to move freely. Your cervical spine also forms a protective tunnel for the upper part of your spinal cord to pass through. This part of your spinal cord contains the spinal nerves that supply your upper body with sensation and movement. When the space between your vertebrae becomes too narrow, part of your vertebrae or your cervical disk can press on your spinal cord or spinal nerves, causing you pain, numbness, or weakness. When these symptoms do not respond to nonsurgical types of treatment, disk surgery may be recommended. Cervical disc begin to collapse and bulge with age; this happens to most people by age 60. But health care providers don’t know why some people have more symptoms from cervical disk degeneration than others.

Symptoms

• Neck pain
• Neck stiffness
• Headache
• Pain that travels down into your shoulders or into your arms
• Weakness of your shoulders, arms, hands, or legs
• Numbness or "pins and needles" feeling in your arms

Benefits of cervical disc replacement

• Disc replacement improves function after surgery. Because the disc replacement devices preserve more normal neck motion, patients are able to reclaim a wider range of head and neck movement after surgery. Increased movement means increased day-to-day function and better quality of life.
• Motion preservation reduces stress on the spine. Traditional fusion surgery locks the treated vertebrae in place. The loss of motion can put stress on adjacent vertebrae and cause further degeneration in the future. Because disc replacement surgery maintains motion and prevents increased stress, it may help protect the adjacent vertebrae from additional degeneration over time.
• Minimally invasive surgery offers a faster recovery. After fusion surgery, patients must be immobilized for a period of time while the fused vertebrae heal. Recovery from disc replacement surgery is much faster; patients have returned to work within four days of surgery. Disc replacement surgery also means that patients don’t have to worry about some of the potential complications of fusion surgery.

Risks Involved

While any surgery carries some risk, disc replacement surgery is a relatively safe procedure. Some potential risks of cervical spine surgery include:

• Reactions to the anesthesia
• Bleeding
• Infection
• Nerve injury
• Spinal fluid leak
• Voice change
• Stroke
• Difficulty breathing
• Difficulty swallowing
• Failure to relieve symptoms
• Broken or loosened artificial disk
• Need for further surgery

There may be other risks, depending on your specific medical condition. Be sure to discuss any concerns with your surgeon before the procedure.

Preparation

Below is a list of some common steps that you may be asked to do.

• Tell your surgeon about any medications you take at home including herbal supplements and over-the-counter medications. You may be asked to stop taking aspirin or other medications that thin your blood and may increase bleeding.
• Discuss with your surgeon if you or someone in your family has any history of reaction to general anesthesia.
• If you smoke, you may be asked to stop smoking well before surgery and avoid smoking for a time after surgery.
• Before surgery you will probably be given instructions on when to stop eating and drinking. It’s common to have nothing to eat or drink after midnight on the night before the procedure.
• Ask your surgeon if you should take your regular medications with a small sip of water on the day of the procedure.

During Surgery

This procedure is usually done under general anesthesia (you are asleep). Medication may be given through the IV to put you to sleep and a tube may be inserted in your throat to protect your airway and supplement your breathing. The actual procedure may last a few hours. This is what may happen once the procedure begins:

1. Monitors are placed to check your heart, blood pressure, and oxygen level.
2. The area of your neck where the incision will be made is cleaned with a special solution to kill germs on the skin.
3. A one- to two-inch incision (surgical cut) is made on the side or front of your neck.
4. The important structures of the neck are carefully moved to the side until the surgeon can see the bones of the vertebrae and the cervical disk.
5. The cervical disk that is being replaced is removed.
6. The artificial disk is secured into the empty disk space.
7. The incision is closed using absorbable sutures (stitches) under the skin. The skin is then carefully closed with sutures that minimize any scarring.
8. A small dressing is applied over the incision, a rigid or soft neck collar may be put on your neck to restrict motion, and you will be taken to the recovery area.

After Surgery

Pain after disc replacement surgery is normal and you may be given pain medication in the recovery area. Most people will need to spend a day or two in the hospital. This is what may happen during your hospital stay:

• Intravenous fluids may be continued until you can drink fluids well by mouth.
• Once you are able to drink normally, you will be able to start eating your normal diet.
• You’ll continue to take pain medication if you need it.
• Your nurses will check your dressing and help you to get out of bed and go to the bathroom.
• You may be given a support collar to wear in the hospital.
• You will be encouraged to get out of bed and move around as soon as you are able to.

Recovery and rehabilitation at home, here’s what you might expect:

• You may need to continue wearing a soft or rigid neck support.
• You will be able to eat your normal diet.
• You may need to return to your surgeon to have sutures removed.
• You will gradually start returning to normal activities. You should ask your surgeon about any activity restrictions and when you can take a regular shower or bath.
• You may start physical therapy after a few weeks.
• You should be able to return to full activities by 4 to 6 weeks.

You need to contact your doctor, if you have any of these problems:

• Fever
• Headache
• Bleeding, redness, swelling, or discharge from your incision site
• Pain that does not respond to pain medication
• Numbness or weakness
• Difficulty swallowing
• Voice change or hoarseness
• Difficulty breathing

Frequently asked questions

What is the success rate of cervical disc replacement?

Success rate was 86% in 60 patients at 6 months and 90% in 30 patients at 1 year, with motion preservation in all patients and no evidence of device migration. Although many subsequent studies have reported good results over time, long-term follow-up results have exposed various problems.

How long does a spinal disc replacement last?

The average age of a patient needing a lumbar disc replacement is about 35 years. This means that to avoid the need for revision surgery, the artificial disc must last at least 50 years.

What happens after cervical disc replacement?

Most commonly, the recovering patient has some pain and soreness at the incision site at the front of the neck. Other symptoms may also be present, such as trouble with swallowing or speaking.

How should I sleep after cervical disc replacement?

The best sleeping position to reduce your pain after surgery is either on your back with your knees bent and a pillow under your knees or on your side with your knees bent and a pillow between your legs.

Should I wear cervical collar to bed?

Now that you are wearing a Cervical Collar it is important for you to resume your normal activities as soon as possible, while remembering to protect your neck. Always wear your collar in bed unless told otherwise by your consultant.

What is the best pillow to use after neck surgery?

• Tri-Core Cervical Pillow.
• Tempur-Pedic Ergo Neck Pillow Firm Support.
• Pancake Pillow Adjustable Layer Pillow.
• Core Products Double Core Select Foam Cervical Support Pillow.
• Pillowise.
• Therapeutica Orthopedic Sleeping Pillow.
• Mediflow Water Pillow.
• Sachi Organics Buckwheat Cylinder Neck Pillow.

How long does it take to recover from a disc replacement?

Recovery can take up to 3 months, but can vary from a few weeks to a few months from patient to patient. The full recovery time after artificial disc replacement can depend on the lifestyle that you follow and your overall health.