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Delhi surgeons perform ‘India’s first’ three level artificial cervical disc replacement surgery

New Delhi: In a rare and complex surgery of the cervical spine, two leading neurosurgeons of Delhi claimed to have performed, for the first time in India, a three level cervical disc prolapse surgery followed by replacement of the patient’s natural disc with an artificial disc to preserve the patient’s range of movement in the neck. According to the surgeons, this is only the second such surgery reported in Asia.

Dr Sunit Mediratta
Dr Sunit Mediratta

Dr Ashish Shrivastav and Dr Sunit Mediratta, consultant neurosurgeons at Indraprastha Apollo Hospitals, New Delhi performed this procedure last month on a 46-year-old man who had come with complaints of neck pain and radiating pain along his upper limbs causing immense discomfort with inability to carry out his day-to-day activity.

“The procedure was successfully carried out over a three-hour period and the patient was allowed to walk the next day. The patient was completely relieved of his pain and was discharged from the hospital three days after the surgery,” said Dr Shrivastav and Dr Mediratta in a statement.

Cervical disc prolapse or slip disc as referred to in common parlance is a common ailment in young active adults and causes neck pain along with radiating pain to the upper limbs; left untreated it can progress to causing weakness of the hands and legs, stiffness of lower limbs and difficulty in walking.

Although commonly most patients present with a single level or two level disc prolapse, the traditional way of treating has been to surgically remove the prolapsed disc and fuse the adjoining cervical vertebra (neck bones) using a bone graft. It takes almost three months for the bones to fuse during which time the patient is advised to wear a cervical collar at all times.

However, the neck movements become restricted using this approach and it also causes additional strain on the adjacent disc spaces, thus for the last few years patients with multilevel cervical disc disease have been offered artificial disc replacement with the idea of preserving the range of motion and decreasing risks of further degeneration of adjacent discs over a period of time. The artificial disc gets immediately fixed snuggly between the bones and does not require a long healing period or the use of a cervical collar for long.

MRI scan of the patient showing three level cervical disc prolapse (arrows)
MRI scan of the patient showing three level cervical disc prolapse (arrows)
Post-operative X-ray of the patient’s neck showing the three artificial discs (arrows)
Post-operative X-ray of the patient’s neck showing the three artificial discs (arrows)

Since the approval of the US FDA for multi level cervical disc replacement in 2008, only a few surgeons have performed three-level cervical disc replacement surgery worldwide.

The usual cost of such surgery would be upwards of $45,000 in the United States for a single level disc replacement. Dr Mediratta informed that they have been able to perform the same surgery at a fraction of the cost here ($9,000 or Rs 6 lakh) even though the surgery involved replacement of three discs.

Although the surgery was performed some time ago, Dr Mediratta said that he wanted to wait for the patient to recover completely and make sure that the surgery was a success before announcing it publically.

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