Minimally Invasive Spine Surgery – Better Than Ever, But Is It Right For You?
In years past, spinal fusion was the best surgical option for patients with a herniated cervical disc—the primary cause of the intense neck pain, as well as headaches, shoulder and arm pain, muscle weakness between the shoulder and hand, and tingling in the arm and fingers. Today, however, more patients are benefiting from artificial cervical disc replacement.
With this in mind, we recently sat with Dr. Edward Hellman, a Castle Connolly Top Doctor who has a thriving practice in South Georgia.
Dr. Hellman, who has extensive experience in placement of artificial discs in both the cervical and lumbar spine, says many patients with neck problems respond well to non-operative care. This can include interventions such as physical therapy, chiropractic care, and nonsurgical procedures such as epidural steroid injections or radio frequency ablation. But for those patients with severe neck problems that require surgery, the artificial disc is an exciting advancement in the field of spinal surgery.
Dr. Hellman explains that the cervical portion of the spine—located in the neck—includes seven vertebrae. Between each of these vertebrae is a disc that provides cushioning to help the neck move and bend. When a disc’s inner core breaks through the disc’s exterior shell, it can press on the nearby nerve roots. This is called a herniated disc.
“Some people have found relief through chiropractic work, physical therapy or pain medications, but there are those who try these steps with no benefit,” Dr. Hellman asserts.
While some herniated discs cause little or no pain, others are quite debilitating.
“Some people have found relief through chiropractic work, physical therapy or pain medications, but there are those who try these steps with no benefit,” Dr. Hellman asserts. He further states that individuals who have been told their only alternative was spinal fusion, might want to consider the cervical disc replacement option.
Dr. Hellman explains that in spinal fusion a motion segment of the neck that normally moves is instrumented in such a fashion that motion is permanently limited in that segment. This often involves the use of a plate and screws and some form of cage or bone. The surgery is commonly referred to as anterior cervical discectomy and fusion (ACDF).
“As you can imagine, limited mobility after surgery can be a deterrent to pursuing ACDF,” Dr. Hellman explains.
In the properly selected patient, a total disc replacement is potentially more successful surgery than a fusion. “With disc replacement, the motion in the segment is maintained, the recovery is quicker, and the long-term prognosis is better,” Dr. Hellman explains. “The disc replacement functions in a similar manner to those undergoing a hip or knee replacement and is used in the spine to remove and replace damaged discs in the spine.”
“It can be a much better option than a fusion for certain patients,” he says. “The results and recovery can be quite dramatic. It is not uncommon for patients to experience near immediate relief in their preoperative radicular pain. And the return to full activity can be much quicker than a fusion…sometimes within days of their surgery.”
Even though disc replacement surgery is more advanced and gaining in popularity, it is still an evolving procedure. Dr. Hellman is board certified and is a fellow of the American Academy of Orthopedic Surgeons and has received extra certification in performing disc replacements in the cervical and lumbar spine. He has held memberships in the North American Spine Society and the Spine Intervention Society. Dr. Hellman has assisted in the training of visiting medical students and has served as an associate professor for the Mercer University College of Medicine and the Medical College of Georgia. He practices at Tifton Regional Medical Center in Tifton, Georgia where he has served as the Chairman of the Department of Surgery and Chief of Staff.