hi this is Dr. Scott Blumenthal. today we're going to be watching surgery for a
herniated disc in the cervical spine through an anterior approach with an
artificial disc. This particular one the mobi-C. alright what we're seeing here is
a standard opening for cervical disc replacement they call the incision in
langurs lines
as you can see it's very bloodless and it doesn't take more than a few minutes
to get to the front of the cervical spine
and you can see not much cutting of tissue either things just kind of get
out of the way and allows you to put a retractor in
What we see here is marking the disc with a needle and then we'll bring an x-ray
to insure that we are at the correct level
this shows us placing these self-retaining retractors and then
hopefully we'll give you a close-up to show you the disk a little bit better
this device is a self-retaining retractor which is very commonly used or
some iteration of it is very commonly used in anterior cervical surgery
next thing we'll be doing will be cutting the disk and this begins the
process of removing the disk all the way back to the spinal cord and spinal
nerves to ensure that everything is freed up and unhinged
what would be putting in our called distracting or retention pins
and this will allow us to open up the disk even more to clean to clean things
out
and although we're showing only a few minutes of the surgery the surgery
itself averages about 45 minutes to 1 hour for one level disk replacement this
is where we get our parallel distraction and then we set the pins to hold that
distraction. distraction it's a very very important part of the case you want this
to be done in a very controlled fashion because how you distract ultimately
determines how that disc replacement is going to look and then subsequently how
it's going to function
so what we're looking at here are these are different angled what we call
curettes and what curettes do is they remove the remaining discs and cartilage
from the bones so that's simply bone on bone and allow us to see back to the
spinal cord and spinal nerves to make sure that they're completely
decompressed this is a trial to see what size disc we want to use we've already
unpinch tall the nerves we've already taken all the discs out we've already
looked at the spinal canal to make sure there's no other pinching from bone
spurs or anything else and we'll pick a device based upon this we've selected a
size and that's the disc that we'll be planning to use we're doing our final
preparations on the disc right now
this particular disk is called the mobi-c
and it's gently tapped into place and as we're tapping it backward looking on
x-ray to make sure that it goes exactly where it's supposed to go
we advanced it basically millimeter by millimeter until it's in its optimum
position
and there's the disc in its final position looks really good, I'm very
pleased with that and we'll take all our pins and retractors out and close her up
what you can see also which is surprising to some people that this type
of surgery is very blood free you can see that there's not even any blood on
the drapes now most people lose more blood from the blood test they have to
take to have surgery or an anesthetic than the whole surgery itself
this is dr. Scott Blumenthal you've seen an artificial disc surgery today with
the Mobe see you can reach us at the Center for disc replacement at Texas
back Institute