Recovery From Cervical Artificial Disc Replacement
SpineUniverse: Walk us through patient recovery from artificial disc replacement.
Many surgeons send the patient home without a soft collar. It’s a matter of physician preference. I put my patients in a soft collar for 2 weeks, but more often than not, patients are sent home with a small dressing and nothing else.
With regard to hospital stay, patients are admitted as an outpatient or overnight¾less than 23.5 hours. That’s our terminology for outpatient surgery. Within one week, my patients are back to driving a car. They can go back to work anywhere from 2-6 weeks after surgery, depending on what type of work they do.
I often send patients to physical therapy, but it’s just for core exercises. The return to normal activities is gradual. I encourage patients to take it easy until I know that the endplates are secured to the bone. Until I’m confident that the healing is complete, I restrict patients from hyperextension, such as leaning the head backwards, and from jogging. Those are my only two restrictions for the first 3 months. Aside from that, they can pretty much do it all.
SpineUniverse: From both surgeon and patient perspectives, how would you rate the levels of satisfaction for this procedure?
Surgeons are pleased with the outcomes they’re getting and patients are pleased because the recovery is relatively quick, all things considered. Everyone knows there are problems common to fusion surgery. One fusion seems to beget another. In other words, you have a fusion at one level, then you come back and get another level done, and so on. While disc replacement may not prevent adjacent segment disease, we certainly have enough data that show the rate of adjacent segment disease is about a quarter to a third of what it is with fusions. Those rates are being borne out by the 7-year data that we now have.
SpineUniverse: Would you say you’re a proponent of disc replacement over fusion, when appropriate?
Absolutely. It’s great for patients. And if I can do a procedure that helps patients maintain motion and reduces stress . . .well, to my way of thinking, that’s wonderful.
SpineUniverse: What advice would you give to surgeons and patients about the procedure?
My advice to other surgeons would be to know the prosthesis you select inside and out. Know every nuance of the artificial disc, and select your patients well.
I would urge patients to make sure they choose a surgeon that has a lot of experience in disc replacement surgery. Be an informed patient and get involved in the treatment process. Pick a surgeon who can give you his/her outcome statistics, not just the national statistics.
SpineUniverse: This has been quite interesting. Any final remarks or pearls of wisdom you’d like to add?
Cervical disc replacement is one of these advancements in medicine that’s become a game changer for both patients and surgeons. To know that we can return a patient to near normalcy is extremely gratifying. An artificial disc can’t replace a human disc, but it’s the best that we can do today, and in the future, we might be transplanting cadaver discs, or we’ll have stem cells that perhaps at early stages of degeneration can be restored. In my point of view, it is not a destructive operation. It’s a reconstructive operation that takes the patient back toward a normal life.
To learn about Dr. Guyer’s practice, click here.