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Disk Replacement Surgery Provides Relief For Pain Sufferers

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RALEIGH, N.C. — If you have neck pain, a good shoulder massage might help. For serious neck pain, people try physical therapy, pain medication, acupuncture or epidural steroid injections. Once the conservative treatments are exhausted, many people turn to surgery to relieve the pain.

For some people, the problem is a herniated disk. The disk is cartilage that acts as a shock absorber between bones of the vertebrae. If a disk bulges out, it can pinch the nerves, causing pain.

At WakeMed in Raleigh, 32-year-old Elliot Shapiro became only the second person in the country to receive a new type of implant called a neo-disc by Nuvasive.

Shapiro, who is a freelance writer, found that sitting at a computer was a pain in the neck. He tried everything from acupuncture to epidural steroid injections to find relief.

"And then about three months ago, I started having just unbelievable spasms," said Shapiro.

Shapiro was diagnosed with a herniated disk. Most people in his position get surgery to fuse the surrounding vertebrae.

"The downside to that operation is it fuses the vertebrae together so that they can't move and it puts work on the disk above and below," said neurosurgeon Dr. Kenneth Rich.

Rich said most people who get neck fusion surgery end up with more neck pain eventually because of the added strain on surrounding disks. Rich included Elliot in a clinical trial for the new disk replacement.

Through an incision in the front of the neck, Dr. Rich exposes the damaged disk, removes it and replaces it with a soft replacement disk. It is a wafer of silicon that is squishy, but firm to the touch, surrounded by a weave of polyethylene material.

Once it is inserted into the disk gap, two flaps are screwed down on the upper and lower vertebrae to hold it in place.

A few days later, Shapiro is past the toughest recovery period.

"I had a lot of trouble swallowing the first couple of days," he said.

For two to three months, Shapiro said he will slowly build up his activity level and then do things he has not done for years.

"I'd like to go back to playing some sports some day -- at least get back on the softball field," he said.

The neo-disc is not entirely new. It has been used in Great Britain for several years. Rich said, in theory, a similar disk could be used for herniated disks in the lower back. However, he said the vertebrae in the lower back carry more weight than those in the neck and would require a more substantial shock-absorbing capability for a disk there.

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