Cervical - APEX Spine 2021

Almost 150 artificial disk replacements per year

At times an artificial disk replacement may seem indicated to help the patient to get well again.
Dr. Helmbrecht with about 150 annual implantations ranges among the most experienced spine surgeons.

Thanks to progress in implant development modern artificial disk replacements are fitted ideally to the functional setting of the cervical spine and allow for natural movement – preserving by this means the mobility of the neck. Additionally their elasticity lets them work as shock absorbers just like their natural counterparts. This helps to prevent the adjacent sections of the spine from undue stresses.

How is surgery carried out?

Insertion of an artificial disk replacement is done through a small incision at the neck. After removal of the prolapsed disk the artificial disk replacement is adjusted between the vertebrae. It is fixed with two titanium plates allowing for optimal adhesion of the implant to the bone so that a loosening is mitigated. Between the two titanium plates there is a polymeric nucleus (polyethylene) and another polymer (polyurethane) is used to encase the prosthesis and to seal it off the surrounding tissues.

The intervention is done under general anesthesia and takes about one hour. Already two hours after the surgery you can walk by yourself and two days later you may go back home again.

Only in rare cases a prosthesis cannot be used. This is the case in osteoporosis, tumors, myelopathy (changes of the spinal cord) or if degeneration of the disk and the facet joints is too severe. In such cases a fusion is done after thorough decompression. For this purpose we use a cage made of PEEK (a synthetic material that is highly biocompatible).

The intervention is done under general anesthesia and takes about one hour. Already two hours after the surgery you can walk by yourself and two days later you may go back home again.

Artificial disk replacement cervical spine (lateral/frontal view)

What post-operative care is necessary?

For about six weeks you will have to carry a neck brace and then it is recommended to start an individually targeted and professionally supervised physiotherapy.

When may I resume my sports activities?

After about six weeks you should be able to go swimming or to ride your bicycle. Your may gradually resume your usual sports activities after 9 to 12 weeks.

When can I go back to work?

After two weeks you can resume simple office work and slight physical work. You shouldn’t do any hard physical work during the first 8 weeks and then only gradually increase.

What is the success rate?

In the international scientific literature success rates of more than 90% are quoted.

At a glance!

The most important facts at a glance for your convenience
	Fusion surgery	Artificial disk replacement
Risk	The vertebral bodies are fused after the surgery, the natural mobility of the cervical spine is lost. This may lead to undue stresses on adjacent segments For fusion either a bone graft must be implanted (pain at the harvesting site at the iliac crest) or a metal implant is used (foreign body). Mostly and additional metal fixation system is required. There is a risk of injury to the nerve roots from the used fixation screws. This may lead to transient or permanent neurological signs.	Natural mobility of the affected motion segment is greatly restored by surgery Injury of nerve root is extremely rare Fusion of the motion segment is not necessary
Pain	Symptoms often prevail after surgery or new symptoms arise from surgery In the cervical spine surgery is mostly done from the back. This frequently leads to permanent symptoms in the neck musculature	Original neck pain is mostly gone directly after surgery. Slight remaining musculary disturbances rapidly resolve. Surgery is carried out through a small incision (3-5mm) from the front.
After the intervention	As a rule return to full activity takes 6 weeks.	Patient can return to slight movements of the neck already 3 hours after the intervention while wearing a specially adapted neck brace.
Hospital stay	1-2 weeks	3-6 days
Surgery	Substantial removal of bone substance often the vertebral bodies are fixed with metal, carbon or PEEK cages and a metal plate	Only the pain causing disk is removed Access is achieved through a 3-5 cm skin incision from the front. A fixation through cages and metal plates is not necessary Mobility and stability of the spine is preserved
Sport	Sports activities are virtually impossible	After rehabilitation you can resume your usual sports activities
Schedules	Long waiting times are not unusual	In acute cases surgery is possible mostly within one week.

!!! The mobility and normal function of the cervical spine are preserved !!!

All advantages at a glance:

Up-to-date artificial disks provide for a natural mobility and ideal functionality of the damaged cervical spine
Short hospital stay: in general you may go back home three days after the intervention
A adjacent segment degenration can mostly be prevented
Return to moving and walking directly after surgery is possible
Already two weeks after the surgery you may largely resume your usual activities
A high success rate

Dr. Helmbrecht in an interview on “The artificial disk replacement in the cervical spine for neck pain - a valuable option?"

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Cervical Disk Prosthesis