Patient Information Resources

Alpine Physical Therapy
Three Locations
In North, South, and Downtown Missoula
Missoula, MT 59804
Ph: 406-251-2323
Fax: 406-251-2999

Child Orthopedics
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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I'm 35-years-old but thanks to a bad car accident 10 years ago, I have the neck of an 80-year-old woman. Am I too young for a neck replacement?

We assume you are referring to the cervical spine (neck) disc replacement surgery that is now available. The vertebral bones are not removed and replaced, but the disc between the bones is. The goal is to preserve and restore normal spinal movement. After the disc is removed, the ends of the vertebral bodies (called endplates) are smoothed down. The artificial implant is then inserted into the empty disc space and positioned properly. The surgeon uses fluoroscopy (special three-dimensional, real-time X-ray) to guide the implant in place. The surgeon is careful to choose the correct size of implant for each patient and to maintain the proper disc height. Special "teeth" built in to the implant help hold it in place until bone fills in around it. There is no need for a bone graft. You could have had the more traditional procedure called anterior cervical discectomy and fusion (ACDF). With ACDF, the surgeon removes the degenerative disc and fuses the two vertebral bones on either side of the disc together. The hope with arterial disc replacement is that it will reduce the strain placed on the disc and spinal joints as well as provide improved neck motion. Your age is a definite factor. But cervical disc implants have been used in patients from 34 to 67 years old. The cervical implants are new enough that we don't know how well they will hold up over time for each age group. Long-term studies to report on the possibility of adjacent disc disease have been very limited so far. Adjacent disc disease refers to the potential effect of disc replacement on the spinal segments above and below the implant. The definite advantage disc replacement has over fusion is that if it isn't successful, you can always convert (change over) to a fusion. The only way you will know if you are a good candidate for this procedure is to see a spinal surgeon who performs both cervical fusion as well as disc implantation. After a proper evaluation, the choices available to you will be discussed and a decision can be made together. Your age, general health, occupation, activity level, personal goals, and other important factors will be included in that process.


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