Cervical disc prostheses, designed to maintain movement and prevent wear on adjacent healthy discs (adjacent segment disease) after fusion surgeries, yield highly satisfactory results when performed with the correct technique under appropriate indications. Cervical prosthesis surgeries are similar to anterior cervical fusion surgeries, with the herniated disc being removed under a microscope and the prosthesis placed between the vertebral bodies. The goal here is to maintain the continuity of movement between the two vertebrae. In classic fusion surgery, these two vertebrae are fixed together with a cage and plate, aiming for fusion.
Not every patient is suitable for prosthesis surgery. Therefore, patients need to be thoroughly evaluated radiologically before surgery in this regard.
Which Patients Are Not Suitable for Cervical Prosthesis Surgery?
- Presence of instability (abnormal mobility) at the planned surgical level
- Cartilage wear or calcification in the posterior joints (facets) at the planned surgical level
- Presence of rheumatologic diseases and cancer
- Patients with excessive cervical straightening
- Patients with very poor bone quality
Prosthesis surgery is not preferred for these patients.
What Are the Advantages of Prosthesis Surgery?
In prosthesis surgeries, neck movements at the operated level are preserved. In prosthesis surgery, wear on adjacent, untreated healthy discs—commonly seen after classic surgeries—is significantly reduced. This lowers the risk of the patient needing another surgery due to adjacent segment disease, which refers to wear on these discs. While adjacent segment disease generally occurs after 10 years, about 10% of these patients may require repeat surgery. The main goal of using a prosthesis is to eliminate such surgical needs.
What Is the Most Common Complication in Prosthesis Surgery?
Although the rates vary depending on the design of the prosthesis, the most common complication observed after prosthesis surgeries is the formation of excessive bone tissue around the prosthesis, known as heterotopic ossification. This can be seen in 10-20% of cases and may limit the mobility of the prosthesis.
How Long Are Neck Movements Restricted After Prosthesis Surgery?
Usually, neck movements are allowed after a one-week rest period.