Minimally invasive cervical disc replacement surgery entails inserting an artificial cervical disc between two cervical vertebrae after the inter- vertebral disc has been surgically removed in the process of decompressing the spinal cord or a nerve root. The intent of the device is to preserve motion at the disc space. It is an alternative to the use of bone grafts, plates and screws in pursuit of a fusion following procedures such a disc removal, which necessarily eliminates motion at the operated disc space in the neck.
ADR Surgical Procedure
Patient has to take supine position i.e. lying on the back. During surgery, anesthesia is given & ‘endotracheal’ a breathing tube is placed & patient breathes with the help of ventilator. Antibiotics are given through vein or intravenous. Region which has to be operated is cleansed with cleaning solution. Surgical team maintains a bacteria free environment by wearing sterile attires, gloves& putting surgical drapes.
A transverse or oblique incision which is 3- 8 centimetre is made on the left portion of belly button & abdominal muscles are gently moved. The peritoneal sacis are pulled back to the side because they are large blood vessels. Special retractors are used by the surgeon for visualizing the anterior part of intervertebral disc. Later an X-ray helps to confirm the level of spine.
Then with special surgical instruments (like pituitary rongeur, Kerrisonrongeur, & curettes) intervertebral disc is removed. A distractor instrument restores the normal height of disc & also determines the appropriate size of artificial disc that is to be implanted. Prosthesis is carefully adjusted & placed in the disc space with instrument. To confirm its position whether it’s correct or not, Fluoroscopic x-rays are taken.
Later, sterile water containing antibiotics is used to wash out & clean wound area. Strong sutures are used to close deep fascial layer & subcutaneous layers & special surgical glue is used to close the skin. This leaves minimal scar & require no bandage. Surgery usually takes 3-4 hours which again depends on the number of discs to be replaced.
How long is the recovery after artificial disc replacement surgery?
Most people spend one or two nights in the hospital. You may require an extra day or two if for some reason you’re having extra pain or unexpected difficulty. Patients generally recover quickly after an artificial disc replacement. You should be able to get out of bed and walk within a few days. Some people wear a corset or brace for support. As you recover in the hospital, a physical therapist may see you to start you on a few gentle exercises.
You’ll also start a walking program that you are encouraged to continue when you get back home. When you leave the hospital, you should be safe to sit, and walk. Your surgeon will see you within a month to do an X-ray to make sure the disc is in place and holding steady. However, you should avoid lifting things for at least four weeks. You can often return to work after your surgeon has evaluated you, as long as your job does not include heavy lifting. It should be noted that a successful result of the disc replacement means that back symptoms are better but not necessarily perfect. Most studies show that 70 to 80 percent of patients have significantly less back pain and greatly improved function with the operation.
After Surgery Benefits Include
- Motion is restored to normal
- Artificial disc performs the same function as original one like absorption of stress
- There is no need of complex bone graft which has a risk of infection transmission
- Adjacent spinal discs won’t have to bear stress in cervical disc replacement
- Patients recover more quickly in ADS than spinal fusion
- Fewer or rare chances of revision surgical procedure
- Fewer chances of device failures
- Patients who undergo cervical disc replacement hardly need a hard collar surgery
- Quick healing time
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