22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical

Name of the Procedure:

Total Disc Arthroplasty (Artificial Disc), Anterior Approach, Including Discectomy with End Plate Preparation (includes Osteophytectomy for Nerve Root or Spinal Cord Decompression and Microdissection); Single Interspace, Cervical

Summary

Total Disc Arthroplasty is a surgical procedure where a damaged cervical disc in the spine is replaced with an artificial disc. The surgery is performed from the front (anterior) of the neck and involves removing the problematic disc and preparing the bone surfaces for the new disc.

Purpose

This procedure addresses chronic neck pain and other symptoms caused by a degenerated cervical disc. The goal is to alleviate pain, improve neck movement, and maintain stability and alignment of the spine.

Indications

• Chronic neck pain unresponsive to non-surgical treatments
• Degenerative disc disease in the cervical spine
• Cervical disc herniation with nerve root or spinal cord compression
• Symptoms such as numbness, tingling, or weakness in the arms

Preparation

• Pre-operative fasting as directed by the healthcare team
• Discontinuation of certain medications like blood thinners
• Pre-surgical assessments including imaging studies (MRI, CT scans) and physical evaluations
• Blood tests and cardiovascular evaluations as necessary

Procedure Description

1. The patient is placed under general anesthesia.
2. A small incision is made at the front of the neck.
3. The damaged disc is carefully removed (discectomy).
4. Preparation of the end plates of the adjacent vertebrae, which may involve the removal of bone spurs (osteophytectomy).
5. Placement of the artificial disc between the vertebrae.
6. Closure of the incision with sutures or surgical glue.
7. The procedure includes microdiscectomy if necessary to ensure the decompression of the spinal cord or nerve roots.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic or neurosurgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma
• Nerve damage leading to pain, numbness, or weakness
• Failure of the artificial disc
• Adjacent segment disease
• General risks associated with anesthesia

Benefits

• Reduction in neck pain and associated symptoms
• Improved range of motion in the neck
• Preservation of spinal alignment and stability
• Quicker return to normal activities compared to traditional spinal fusion

Recovery

• Hospital stay of 1-2 days post-surgery
• Wearing a cervical collar for a few weeks
• Gradual return to normal activities over 6 to 12 weeks
• Physical therapy to enhance recovery and strengthen neck muscles
• Follow-up appointments to monitor healing and artificial disc position

Alternatives

• Non-surgical treatments like physical therapy, medications, and injections
• Cervical spinal fusion, which immobilizes the affected segment
• Pros: Alternative methods may pose fewer immediate surgical risks.
• Cons: Non-surgical methods may be less effective long-term; fusion limits neck motion compared to total disc arthroplasty.

Patient Experience

• During the procedure: The patient will be under general anesthesia and will not feel pain.
• After the procedure: Some pain and discomfort at the incision site; managed with pain medications.
• Gradual improvement in neck pain and mobility within weeks; full benefits typically in a few months.