Cervical Implants Designed To Preserve Neck Mobility

By Andrew Gorosko

For Mitchell Garden, an orthopedic spinal surgeon, it all comes down to saving your neck.

Dr Garden, who practices at New Milford Hospital, is using a recently approved surgical technique intended to allow some patients to maintain a range of motion in their necks following surgery for cervical degenerative disc disease.

In an interview at the hospital, Dr. Garden explained that he had performed three of six recent surgeries at the hospital in which artificial spinal discs were implanted into the necks of patients.

The use of such surgical stainless steel implants is an appropriate measure in certain cases when a patient has degenerative disc disease or a herniated disc, the doctor said.

Although the implant procedure has been used in Europe for about a decade, such implant surgery was first approved for use in the United States by the US Food and Drug Administration (FDA) last August, Dr Garden said.

The artificial disc implantation involves techniques similar to that of spinal fusion surgery. Spinal fusion, however, can have negative side effects, such as a reduced range of motion in patients’ necks, Dr Garden said.

Cervical disc implantation is intended to preserve a patient’s existing range of neck motion, he said. The technique is currently used to replace a single cervical disc.

The seven cervical vertebrae are the topmost bones of the spine. Intervertebral discs lie between the vertebrae. Those discs form joints that allow for movement of the vertebrae and also hold the vertebrae together.

Cervical disc replacement serves as “motion-preserving technology,” Dr Garden said. The disc replacement is an alternative to spinal fusion for some patients.

The disc implantation surgery, which is known as cervical disc arthroplasty, has shown superior neurological outcomes in clinical tests, according to New Milford Hospital. Those medical tests compared the results of cervical disc replacement surgery with spinal fusion surgery. 

Postsurgical patient pain is minimized and recovery time is relatively short in cervical disc implantation, Dr Garden said.

The technique involves implanting the device through a small incision that is made on the front of a patient’s neck, he said.

“In the spinal [surgical] community, we’ve been waiting for this,” Dr Garden said of the artificial disc implantation.

Such disc replacements may be necessary due to spinal disc disease, or as a result of trauma to the neck, such as the injuries suffered by the victims of automobile accidents.

After the surgery, no supportive collar is worn by the patient, Dr Garden said, adding that he reviews a patient’s medical progress at two weeks and at six weeks after surgery.

Dr Garden termed the artificial disc implantation “a very reasonable alternative” to spinal fusion surgery. In spinal fusion surgery, adjacent vertebral bones may be fused together via a bone graft.

The stainless steel cervical disc implant is a small device which, in effect, is a ball-pivot joint. It consists of a ball that rides within a trough. The artificial joint allows two adjacent vertebrae to flex in relation to one another. Surgical screws are used to affix the device to two adjacent vertebrae.

The implant does not look like the cervical disc which it replaces.

“This [artificial] disc may revolutionize treatment options for surgical patients who normally would have only the option of a motion-restricting process of spinal fusion,” according to Dr Garden.

Medtronic, Inc, the firm that produces the Prestige-brand artificial cervical disc used in the surgery, provides the device in a variety of sizes to allow surgeons to insert a cervical disc implant of the appropriate size in a patient.

Dr Garden’s surgical work mostly involves repairing the upper spines and lower spines of patients.

Dr Garden, of Associated Litc­hfield County Orthopedics in New Milford, received board certification in orthopedic surgery in 2000. He has memberships in the American Academy of Orthopedic Surgeons, the National Association of Spine Surgeons, and the North American Spine Society.