Cervical Artificial Disc Replacement Surgery

Factors To Consider When Choosing A Spine Doctor

1. Experience: The most important factor to consider is experience. There is no substitute. Repetition yields excellence in results. When choosing a surgeon to treat the cervical spine, ask how many of these procedures he or she performs on a routine basis, and what are the outcomes. In addition, ask whether prior patients would be willing to discuss their pre and post-operative journeys.
   
   
2. Judgment: While experience does lead to technical expertise and improved outcomes, it also leads to better clinical judgment. In many ways, a doctor’s judgment is even more important than his or her technical skill, because a great deal of consideration goes into deciding whether a patient even needs surgery, and if so, what type of surgery. This careful consideration cannot be rushed, and cannot be made with a cookie-cutter approach. A surgical decision can never be made based on MRI findings alone (beware of doctors who offer free MRI reviews, without an evaluation or examination). Rather, MRI findings must be interpreted within the context of what the patient reports to the doctor, and what the doctor finds on a careful examination. It is only when the patient’s symptoms, findings on exam, and MRI results closely correlate can a surgical decision be made. Furthermore, this decision can only be made after all conservative options have been exhausted.
   
   
3. Conservative Approach: When choosing a spine doctor, make sure he or she has a very conservative approach to care, offering surgery only as a last resort. The vast majority of patients (>95%) who suffer from spine ailments do not require surgery, even if their MRIs look severely abnormal. The human body has a tremendous capacity to heal itself, and it is the spine doctor’s job to show how that can be achieved. Surgery should be reserved only for those rare cases where this healing process is not possible.
   
   
4. Breadth of knowledge and skills: There are over 200 distinct types of operations that can be offered for the treatment of spine conditions. Some can be performed via same-day, minimally invasive approaches, while others require large incisions with titanium hardware for complex reconstructions. Every one of these operations represents a tool in the surgeon’s armamentarium, uniquely suited to address a specific surgical need. Unfortunately, not all surgeons have a broad range of surgical skills. Some may limit themselves to the simpler procedures, that are only effective for more routine conditions. However, if a condition is more complex, they may be out of their comfort zone, or they may offer surgical solutions that are not appropriate for a unique circumstance. Ask the surgeon about the range of spine conditions he or she treats, from simple disc herniation to scoliotic deformities. Is the surgeon equally comfortable with a multi-level deformity correction as with a microdiscectomy? Can the surgeon explain the difference between cervical disc replacement versus spinal fusion, and offer either technique if appropriate? Many surgeons will offer cervical fusion simply because they lack qualifications for disc replacement.
   
   
5. Time spent listening and educating: Many surgeons rush to diagnose off an MRI scan. This is the primary reason that so many patients feel dissatisfied with the results of their spine surgery. The surgery may have been performed well, but there continues to be severe pain and dysfunction, causing many to wish they had never undergone surgery to begin with. Why does this happen so often? Because most spine surgery is performed for something that cannot be measured – i.e. pain. Pain is not like temperature or blood pressure, which can be objectively quantified and treated if too high. Rather, pain is very subjective; something that causes misery to one person may be minimally bothersome to another. To further complicate matters, pain is difficult to localize. Many things in the spine can cause pain, such as herniated discs, unstable facet joints, SI joints, or compressed nerve roots. Unfortunately, these can be packed very close together anatomically, and can all cause pain in the same general area. Finally, a joint or disc can look abnormal on X-Ray or MRI, but not cause pain.

Considering all these factors, it can be very difficult to accurately identify the pain generator in any particular patient. If the original diagnosis is inaccurate, then even well-executed spine surgery can leave the patient in pain, because the true source of pain was never accurately identified. Worse, there may be unnecessary complications from surgery, and scar tissue formation, that creates even more pain.

How CNSO Can Alleviate Disc Pain

The only way to overcome the difficult problem of accurate diagnosis in spine care is this – the doctor must spend enough time listening to the patient and asking a lot of questions. With enough time, important clues in the patient’s story can help a doctor identify the underlying problem. The doctor must also perform a thorough and detailed examination searching for all of the signs that lead to a proper diagnosis. All of the findings then will be correlated with imaging study results and the correct pain generator will be identified.

The CNSO philosophy is to treat the patient, not the MRI. Patients receive comprehensive and coordinated care so they can resume a healthy, pain-free lifestyle by working with the CNSO leading board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. CNSO offers multiple convenient locations spanning northern New Jersey, including Bergen, Passaic, Essex, Morris, and Hudson counties. Learn how the doctors at CNSO can alleviate pain with cervical disc replacement surgery by contacting them today.