In his latest installment to the Total Spine series of instructional videos, Dr. Paul McCormick describes retropleural thoracotomy, a surgical technique used to treat complex spinal conditions of the thoracic and lumbar spine. “Retropleural thoracotomy is an important...
Arthroplasty (Artificial Disc Replacement)
|What is an Artificial Disc Replacement?|
Artificial disc replacement, also known as arthroplasty, is the replacement of a damaged spinal disc with an artificial (manufactured) disc.
An artificial disc is designed to support the vertebrae while still allowing backward and forward bending, side-to-side bending, and turning. Many artificial discs have been approved for use by the Food and Drug Administration (FDA). In general, they are composed of two endplates that move and slide on a central core. They are composed of metals like titanium or cobalt and sometimes a plastic such as polyethylene or polyurethane.
|When is this Procedure Performed?|
The vertebral column (backbone) is made up of 33 vertebrae. Between each set of vertebrae is a “cushion” called a disc. Age, genetics, and everyday wear and tear can contribute to disc damage and degeneration or herniation. Disc degeneration or herniation may cause pain, weakness, and numbness that radiate (spread) into the shoulders and arms.
Many patients with degenerated or herniated discs respond well to nonoperative treatment, such as physical therapy, injections, and neck braces. These measures are often effective in relieving symptoms, and they avoid the risks that come with any kind of surgery. However, if patients are experiencing severe neck and/or arm pain, and/or if nonoperative measures do not provide symptom relief, arthroplasty may be considered.
The best candidates for arthroplasty are younger patients who have a single disc herniation and normal spinal motion at the level of the disc. In some patients, replacement of more than one disc is possible. Older patients who have significant arthritis, bone spurs and limited mobility at the disc level are generally not good candidates for arthroplasty.
The neurosurgeons at The Spine Hospital at the Neurological Institute of New York are experienced in forming treatment plans that best suit individual patients and cases.
|How is this Procedure Performed?|
This procedure is performed under general anesthesia.
|How Should I Prepare for this Procedure?|
Make sure to tell your doctor about any medications that you’re taking, including over the counter medication and supplements, especially medications that can thin your blood such as aspirin. Your doctor may recommend you stop taking these medications before your procedure. To make it easier, write all of your medications down before the day of surgery and share them with your doctor.
Be sure to tell your doctor if you have an allergy to any medications, food or latex (some surgical gloves are made of latex).
On the day of surgery, remove any nail polish or acrylic nails, do not wear makeup and remove all jewelry. If staying overnight, bring items that may be needed, such as a toothbrush, toothpaste, and dentures.
|What Should I Expect After the Procedure?|
Any type of surgery is like an injury, and an artificial disc replacement is no different. There will be some discomfort and limited motion for a few weeks. You may need some pain medication for a short period of time. Your activity may be limited for a few weeks, but in most cases you may increase your level of activity as you feel comfortable. Activities such as driving and returning to work depend on your own personal comfort and safety level.
Your surgeon will likely schedule a follow-up appointment 4-6 weeks after surgery. At this appointment, an X-ray will be taken to see how the bones are healing. At this appointment, you and your surgeon will discuss physical therapy and a return to more strenuous physical activity.
|Preparing for Your Appointment|
Drs. Paul C. McCormick, Michael G. Kaiser and Patrick C. Reid are experts in artificial disc replacement.
Helpful Surgery Overviews
Dr. McCormick will choose the treatment method specific to each patient and situation. Some of the condition’s treatment options may be listed below.
Dr McCormick video on microsurgical resection of a synovial cyst causing severe lumbar spinal stenosis published in Operative Neurosurgery
Synovial Cysts are a benign and fairly common condition in adult patients. They can arise in most joints throughout the body. In most cases they are asymptomatic but in the spine they can enlarge to produce severe spinal stenosis and pressure on the spinal nerves...
Dr. McCormick invited speaker at 37th Annual Meeting of the Joint Section on Disorders of the Spine and Peripheral Nerves
Dr. McCormick was a featured speaker at the recent 37th Annual Joint Spine Section Annual Spine Summit meeting held in San Diego. He presented at the Innovative Technology Special Session: Operative Video Segments. His presentation was entitled “Intramedullary Tumor,...