If you are considering having cervical artificial disc replacement microsurgery to relieve pressure on the nerve roots in your spine while preserving fluid movement of the neck, speak to your doctor about the benefits versus the risks that may be involved in the procedure. While microsurgical disc replacement is less invasive than the traditional spinal fusion, many of the potential risks--including blood loss, spinal fluid leak, infection, injury to the nerve root, paralysis and death--are the same.
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Loss of Motion
The purpose of microendoscopic cervical decompression or artificial disc replacement microsurgery is to relieve the pressure on the nerves and spine caused by a degenerated disc while maintaining fluid motion in the spinal column. Unlike spinal fusion, where the affected disc is removed (discectomy) and the adjacent discs of the spine are fused together to provide stability while relieving pressure, artificial disc replacement ideally allows for greater range of motion in the neck post-surgery. In rare instances, however, the bones of the spine may refuse, through a process called spontaneous ankylosis, leading to a loss of flexibility and motion in the neck.
As any surgery, there is a slight risk of infection when an incision has the potential of allowing bacteria to enter into the bloodstream. Infections affecting the skin may be treatable with oral or injected antibiotics, but sometimes further surgery may be required to address deeper infections of the muscle, tissue and bone.
Though rare in cervical surgery, thrombophlebitis (blood clots) may occur during or post-surgery. When the clots break off, they can travel to the patient's lungs, brain or heart, causing an embolism, which may lead to a stroke, heart attack or a reduction of blood flow to a portion of the body. In order to prevent blood clots from forming, the patient may use blood-thinning medications prior to surgery.
When an implanted artificial disc sinks into or above the vertebral body, neurologic compression and the symptoms associated with the condition may occur again. In such cases, further surgery may be necessary to restore the disc to its proper position and relieve the pressure.
It is possible that the implant may degenerate over time due to repetitive motion, causing a breakdown of tiny bits of material from the artificial disc surface. If this occurs, the patient's immune system may react to the foreign substance in the body, causing painful immunological responses. The integrity of the implant also may be affected, causing a loosening or failure of the artificial disc. When the artificial disc fails or breaks apart in the body, further surgery is required to replace the disc.
During any spinal surgery, the nerves of the spinal column may be injured by an improper cut, bump or manipulation of the nerve tissue. The result can be swelling and/or temporary or permanent loss of sensation, function or strength to the muscles and skin connected to the affected nerve. When the muscles associated with the bladder are affected, temporary or permanent incontinence may occur. If spinal fluid leaks during the surgery or when the artificial disc is not correctly placed, further or increased compression or paralysis may occur, requiring further surgery.
There is a slight risk that blood vessels at the front of the spine may be injured during surgery, causing a loss of blood. In case of extreme blood loss, a blood transfusion may become necessary.
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