Patients

Patient Information – Cervical Degenerative Disc Disease

While almost everyone shows signs of wear and tear on their spinal discs as they grow older, the good news is that there’s help for those who need it.

Cervical disc disease: More than just a pain in the neck

Your cervical spine consists of the seven bones, or vertebrae, in your neck and the discs between those vertebrae. These discs act like shock absorbers which not only stabilize your neck, but also allow it to swivel smoothly from side to side and bend both forward and back.

As people age, their discs become worn and can begin to degenerate, narrowing the space between the vertebrae and possibly pinching the roots of nerves. Some form of this degenerative process, which is known as cervical degenerative disc disease, occurs in the majority of people over age 40.

Cervical disc degeneration is usually marked by decreased flexibility of the neck accompanied by stiffness and pain, especially later in the day. The discomfort and stiffness can even radiate down to shoulders, arms, and hands, causing pain, numbness, or weakness.

Obtaining a proper diagnosis

If you have neck pain and suspect that you may be suffering from degenerative disc disease, be sure to see your doctor.

Only a physician can render an authoritative diagnosis based on your medical history and a physical examination, which will likely include a neurological exam to test your strength, reflexes, and the sensitivity in your arms and hands, if affected. Your doctor may also order imaging tests such as X-rays, MRIs, or CT scans to assist in pinpointing the source of your neck pain.

Possible treatments

You should consult a physician not only for an accurate diagnosis, but also for an appropriate plan of care. When deciding on a plan of care, your doctor will help you select from a wide range of treatment options that cover both conservative and more advanced measures.

Non-operative treatment of symptoms

Usually the first course of treatment for people with neck pain, is a combination of non-invasive measures—including physical therapy, physiatry, pain management, or alternative medicine—which may be prescribed to help reduce pain and increase range of motion. A similar plan of care is also commonly chosen for managing the issues sometimes associated with chronic neck pain, like insomnia or depression.

While early uses of non-operative treatments have been shown to accelerate healing, the duration of such treatments varies greatly from one person to the next, based in part on careful monitoring of the patient by their physician.

Surgical treatment of symptoms

Your doctor may recommend a surgical treatment if more conservative measures, such as physical therapy and medication, fail to adequately ease your neck pain or help you increase activity. The primary surgery for degenerative disc disease is discectomy, which is the removal of thedeteriorating disc that is causing neck pain and stiffness, followed by either a spinal fusion or total disc replacement procedure.

Spinal fusion surgery

Historically, the most common surgery for treating a degenerative condition in the cervical spine has been spinal fusion. When a spinal fusion is performed, two or more adjacent vertebrae are permanently joined together, usually by means of bone grafts and metal plates and screws. This procedure stabilizes the spine and hopefully provides some relief from pain.

While spinal fusion has proved helpful for many patients, the joining of two or more vertebrae obviously reduces flexibility in the affected segment of the spine. This loss of motion can provide some relief from pain, but the permanent limitation in mobility it imposes can introduce new problems.

An especially troubling concern is that the fusion procedure can encourage degeneration in adjacent spinal segments, ultimately creating a need for additional fusions in those affected areas. This can perpetuate a cycle of spreading spinal degeneration and pain, progressively reducing flexibility, as more fusions are performed.

Total disc replacement surgery

Much like it sounds, total disc replacement surgery involves replacing one of the body’s natural spinal discs with a new, artificial one.

The replacement cervical disc restores much of the spine’s natural range of motion, alleviating and in some cases eliminating the neck pain, stiffness, and decreased range of motion caused by cervical degenerative disc disease.

It should also be noted that in most cases, total disc replacement surgery does not share spinal fusion’s potential for adjacent segment degeneration (ASD) and the additional procedures that ASD sometimes makes necessary.

The importance of replacement disc composition and design

In determining whether to recommend total disc replacement as a treatment option for you, your doctor will evaluate many different factors, two of which are the design and composition of the replacement disc itself. Dymicron® developed its Triadyme®-C cervical total disc replacement (cTDR) device to eliminate many of the shortcomings of existing devices, and improve upon their strengths.

The effectiveness of many currently marketed devices is limited bycompromises in design or material composition. For instance, some devices cannot accurately reproduce the motion exhibited by natural cervical discs, allowing for unconstrained motion that can result in damage to other spinal structures.

Other devices permit correct motion, but are susceptible to material degradation, which can lead to compromised function and the release of potentially problematic wear debris.

In addition, many current-generation artificial discs are incompatible with imaging systems like CT scans or MRIs because the materials from which they are made may block or partially obscure the visualizations required to render accurate diagnoses.

Triadyme-C: Next-generation cTDR device technology

Dymicron’s Triadyme-C device, by contrast, provides a combination of benefits most currently marketed devices cannot offer: natural motion, extreme durability, and compatibility with diagnostic equipment.

Triadyme-C’s natural motion design mimics the original cervical disc to help protect surrounding nerves and joints. The durability of its wear surface, made from biocompatible, man-made diamond, one of the most durable materials on Earth, reduces the possibility it will wear out or produce harmful wear debris. The materials from which the Triadyme-C disc is manufactured are X-ray friendly and cause minimal MRI artifact.

In short, we believe that the next-generation Triadyme-C cervical total disc replacement device offers both the durability and the biocompatibility to alleviate some of the most common problems associated with cervical disc replacement.

What to expect during disc replacement surgery

If your doctor concludes that you have cervical degenerative disc disease and recommends total disc replacement as your best treatment option, you will be given a general anesthesia that will render you unconscious and unable to feel any pain from the procedure.

A small incision will be made in the front of your neck to provide access to your cervical spine. The damaged disc will be removed and replaced by a cervical total disc replacement (cTDR) device in a size carefully selected to match your anatomy, then the incision will be closed.

What to expect after disc replacement surgery

Following your surgery, your doctor will provide you with a specific set of instructions regarding activities and follow-up care. Some form of physical therapy will likely be prescribed to contribute to the healing and strengthening of your cervical spine, and you should expect to see your doctor for subsequent exams designed to assess and aid your recovery.

This information is not intended to be used as a substitute for talking with your doctor. Be sure to consult a physician regarding your diagnosisand treatment.