Methods of treatment


Implantation of cervical spine intervertebral disc prostheses


Every year, hundreds of thousands of adults are diagnosed with cervical intervertebral
disc disorders, a degenerative disease of the upper spine which can cause pain and
numbness in the neck, shoulders arms and even the hands. Here, we want to give you
a better understanding of cervical disc disorders and offer certain options for their
treatment. This page describes a cervical disc prosthesis, a unique and unusual
technology available for the treatment of these painful degenerative disorders of
the cervical spine.


What is the cervical spine?


Degeneration of the cervical discs
With increasing age, the cervical intervertebral discs become increasingly flatter and worn. The flattening of an intervertebral disc reduces the spacing between the vertebrae, so that not only the disc itself but also the surrounding joints, muscles and nerves are placed under more intensive strain. This process is referred to as intervertebral disc degeneration of the cervical spine and can cause a number of painful phenomena.

Complaints which can result from disc degeneration of the cervical spine

Ruptured disc
A ruptured disc, known as nucleus pulposus prolapse, occurs when the strain on the surrounding vertebrae causes ruptures of the outer band (fibrous ring) of the disc. The rupturing can cause the central nucleus of the disc to bulge out or even become completely separated, resulting in pressure on the nearby nerves or the spinal cord. This pressure on the nerves can cause pain or weakness in certain parts of the body, depending on which nerves are affected.


Bone spurs (osteophytes)
Bone spurs, also called osteophytes, are tiny bone segments which form over a period of time due to increased strain on the vertebrae. Normally, these spurs only cause occasional stiffness or pain in the neck region. However, osteophytes, just as with a ruptured disc, can press against nearby nerves or the spinal cord and cause pain or weakness in certain parts of the body. Read more about endoscopic intervertebral disc operations here.

Symptoms of cervical disc disease

Although many people suffer from cervical disc degeneration with increasing age, the disorder seldom causes severe symptoms. Normally, the symptoms for cervical disc degeneration are mild, such as neck and shoulder pain, stiffness of the neck, or occasionally headaches. However, the symptoms for cervical disc degeneration can become more severe when nerves are pinched by bone spurs or a ruptured disc. This can lead to the painful conditions referred to as radiculopathy and cervical myelopathy.

Radiculopathy
– When spinal nerves are pinched, this can cause pain, weakness or numbness in the neck, shoulders, arms and hands. This is often perceived as piercing arm pain.

Cervical myelopathy – Sometimes the spinal cord itself is affected, which can cause severe pain or weakness in the arms and legs. This pain may be associated with difficulties walking or using the hands.

Diagnosis


We will document your medical history and perform a medical examination to understand your symptoms and to determine whether a nerve or the spinal cord is affected by the conditions arising from cervical disc degeneration.

With the help of magnetic resonance tomography (MRT) examinations and x-ray images we can detect the degeneration which could be the cause of your pain. Your posture, the freedom of movement of your neck, your reflexes, your muscle strength, and the painful regions are all assessed during the examination. If the examination indicates cervical disc degeneration, we will order an x-ray examination or an MRT examination in order to assess the condition of your intervertebral discs, nerves and spinal cord and choose a suitable method of treatment.

Treatment of degenerative cervical diseases

Current treatment options
Non-invasive or conservative treatment options are sufficient for alleviating the symptoms of degenerative cervical disease in most patients. These treatment options can include a combination of rest, physical therapy, and pain tablets or anti-inflammatory medication. Patients who do not respond to this treatment and still have pain or numbness may have to undergo surgery. Within the scope of surgical treatment, the ruptured disc and the bone spurs (osteophytes) causing your symptoms are removed. This process is referred to as decompression.

Both conservative and surgical treatment methods should alleviate your pain symptoms. Your doctor will determine the best treatment option, based on the severity of your degenerative disease.


Implantation of a cervical disc prosthesis
If a surgical procedure is necessary, we will remove the damaged disc. The space between the vertebrae is then filled with a special implant, referred to as the intervertebral disc prosthesis. The disc prosthesis serves to give the optimal spacing between the vertebrae and, at the same time, is capable of maintaining a more natural movement.



The M6 cervical disc prosthesis


Due to its unique design, based on the properties of a natural intervertebral disc, the M6 cervical disc prosthesis offers an innovative option for the implantation of cervical disc prostheses.

The M6, designed to replicate the natural vertebral disc, is the only disc prosthesis that has a core prosthesis (made from polyurethane) and a woven fibre ring (made from polyethylene). The core prosthesis and ring prosthesis of the M6 have the same movement features as a natural intervertebral disc.


Together, the core and ring prostheses of the M6 offer impressive capabilities and a controlled natural freedom of movement along each vertebra. This "natural" movement gives you the freedom to move your neck naturally, while minimising the strain on neighbouring discs and other important vertebral joints.
The M6 has two external plates with a titanium wedge for anchoring the disc in the bone structure of the vertebra. These external plates are coated with a porous titanium spray which promotes bone growth into the metal plates, ensuring the long-term fixation and stability of the disc in the bone.

The procedure


What takes place during the operation?
During the vertebral disc replacement operation, a tiny incision measuring 3 to 4 cm is made on the front side of the neck in order to provide access to the cervical spine. The damaged intervertebral disc is then removed (discectomy). The pressure on the nerve is then reduced (decompression).


The M6 cervical disc is then inserted in the resulting space with special precise instruments. Following positioning of the M6, the incision is closed.


[Translate to Englisch:] Nach Platzierung der M6 wird der Einschnitt geschlossen.


What can I expect following the operation?
Following the operation, we will give you guidelines for activities and post-operative care before releasing you from the hospital. We have had very good experience with medical strengthening therapy. With this method, you can actively contribute to the healing and strengthening of your cervical spine. We will perform follow-up examinations after the operation in order to assess your recovery process..



You will be able to move the cervical spine normally in all six directions again, and it will have almost the entire function of a healthy intervertebral disc. Patients therefore need not worry that neighbouring vertebrae could be overstressed.

Which patients can profit from the intervertebral disc prosthesis?


Above all, the entire clinical picture and also the state of health and age of the patient must be considered. The bone quality is also important, as the prosthesis must grow firmly into the bone structure. This is e.g. not possible for patients suffering from an advanced stage of osteoporosis.


Here you will find the information as pdf-file


Methods of treatment



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