Herniated Discs: New Treatment Option Relieves Pain, Preserves Mobility

Posted by Brigham and Women's Hospital July 19, 2016

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In artificial disc replacement (ADR), the damaged disc is removed and replaced with an artificial one that moves and shifts like a real disc.

Contributor: John H. Chi, MD, MPH, Director of Neurosurgical Spine Cancer and a spine surgeon in the Department of Neurosurgery at Brigham and Women’s Hospital. Dr. Chi is also an Assistant Professor of Neurosurgery at Harvard Medical School.

If you are experiencing numbness and pain in your arms and shoulder, it may be a sign of a herniated disc in your neck (the cervical region of the spine).

“A herniated disc occurs when the soft inner gel that cushions the spine’s vertebrae protrudes into the spinal canal, placing pressure on nearby nerves. This pressure can lead to pain, tingling, numbness or weakness in the shoulders and arms,” says Dr. Chi.

A herniated cervical disc may be managed with medication, physical therapy, and pain management. When patients continue to experience symptoms, surgery may be recommended .

Balancing Pain Relief versus Mobility

Until recently, patients requiring surgery for cervical disc herniation had one option, anterior cervical disc fusion (ACDF), in which the damaged disc is removed and repaired to help relieve pressure on the nerves and the spinal cord. The ACDF procedure also requires the bones above and below the repaired disc to be fused together.

Though ACDF relieves the pain caused by a herniated cervical disc, some patients may experience a reduction in their range of motion due to the fusion of discs in the neck. Furthermore, there is a chance that discs adjacent to the fusion may later herniate, requiring a second surgery.

 Artificial Disc Replacement to Preserve Range of Motion

Today, spine surgeons can offer certain patients with cervical disc herniation another option – artificial disc replacement (ADR). During the ADR procedure, the damaged disc is removed and replaced with an artificial one that moves and shifts like a real disc, preserving a patient’s range of motion.

Recently, Dr. Chi performed an ADR procedure on a patient who had previously undergone disc fusion (ACDF). Though the disc fusion initially relieved the patient’s pain, a disc adjacent to the fusion also herniated. The patient started experiencing significant pain again. This time, the patient opted to undergo ADR. Compared to his first surgery, Dr. Chi’s patient had a shorter hospital stay, a faster recovery, and maintained his full range of motion while finding relief from his chronic pain.

Are You a Candidate for Artificial Disc Replacement?

Artificial disc replacement is not for everyone. You may be a candidate for ADR if you are younger than 55 years and have been experiencing symptoms for at least three months but not longer than 18 months.

It’s not known how long artificial discs will last; however, they have been in worldwide use for almost 20 years and for 12 years in the U.S. So far, there has been no evidence to suggest that artificial discs will require replacement after a certain period of time.  Research also indicates that ADRs may lead to better outcomes than fusion.  Dr. Chi advises checking with your insurer to verify coverage if you are considering ADR.

Learn more about the Comprehensive Spine Center at Brigham and Women’s Hospital.

-Jamie R.

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Spine Surgery: When Nothing Else Will Do

Posted by Brigham and Women's Hospital February 11, 2014

Cervical spine surgery patient - Diane Daigneau

Diane is back to work and play after cervical spine surgery.

For many years, Diane Daigneau of Woburn, MA, was able to successfully manage her back and neck pain. Through occasional chiropractic treatments and mild pain relief medications, she was able to continue to work and play.

A few years ago, however, she discovered that circumstances can change dramatically, to the point where even the best non-surgical care fails to provide adequate relief. Such was the case during the summer of 2013, when the pain radiating through Diane’s back, neck, and arms had become so debilitating and persistent that no physician was recommending anything other than cervical spine (neck) surgery.

From Manageable to Intolerable

Diane likes making things pretty. More than that, it’s her job.

She often spends several hours hovering over a single piece of furniture while meticulously applying delicate gold or silver leafing, or some other type of elegant exterior. It’s a mentally and physically demanding job, particularly for someone who has struggled with back and neck pain. But Diane’s pain was never so bad that she ever worried about not being able to do her job or any other enjoyable pursuits. That changed suddenly during a family vacation at the end of July 2013.

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