22864 Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical

Name of the Procedure:

Removal of Total Disc Arthroplasty (Artificial Disc), Anterior Approach, Single Interspace; Cervical

Summary

This surgical procedure involves removing an artificial cervical (neck) disc that was previously implanted. The surgeon accesses the disc through the front (anterior) of the neck.

Purpose

This procedure addresses complications or failures associated with a previously implanted artificial cervical disc. Goals include relieving pain, restoring neck function, and preventing further complications.

Indications

• Persistent pain or discomfort despite the artificial disc
• Disc malfunction or dislodgement
• Infection around the artificial disc
• Nerve impingement or spinal cord compression
• Patient's intolerance to the artificial disc

Preparation

• Fasting for at least 8 hours before surgery.
• Discontinuing certain medications like blood thinners under doctor's guidance.
• Preoperative imaging studies (e.g., MRI, CT scans) to assess disc condition.
• Pre-surgical clearance from a primary care physician or anesthesiologist.

Procedure Description

1. The patient is placed under general anesthesia.
2. A small incision is made at the front of the neck (anterior approach).
3. The surgeon carefully moves aside muscles, nerves, and other tissues to access the cervical spine.
4. The artificial disc is located and meticulously removed.
5. The interspace is inspected and treated as necessary, potentially with a bone graft or spinal fusion.
6. The incision is closed with sutures or staples.

Tools: Surgical scalpel, retractors, specialized spinal instruments, and possibly imaging technology. Anesthesia: General anesthesia.

Duration

The procedure typically takes 2-3 hours.

Setting

The procedure is performed in a hospital operating room or surgical center.

Personnel

• Orthopedic or Neurosurgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Spinal cord injury
• Thrombosis
• Complications from anesthesia
• Possible need for additional surgeries

Benefits

• Relief from pain and discomfort
• Restoration of neck function and range of motion
• Prevention of further neurological complications
• Improved quality of life

Recovery

• Hospital stay of 1-2 days post-procedure.
• Pain management with prescribed medications.
• Wearing a cervical collar for several weeks.
• Gradual return to normal activities as advised by the surgeon.
• Physical therapy may be recommended.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Revision surgery to replace the artificial disc
• Cervical spinal fusion
• Conservative treatments like physical therapy, medication, or injections

Pros and Cons:

• Alternatives may have variable success rates and recovery times.
• Revision surgery may extend the benefits of the initial implant.
• Fusion restricts motion but stabilizes the spine.

Patient Experience

During the procedure: The patient is under general anesthesia and feels no pain. Post-procedure: Some discomfort and pain managed with medication, temporary restricted neck movement, gradual improvement in symptoms.