Cervical Disc Surgery

Comparing Types Of Cervical Disc Surgery – Disc Replacement Versus Cervical Fusion

Cervical disc surgery is often recommended in cases of cervical disc disease, when other approaches including physical therapy and drug therapy do not provide enough pain relief or improvement in neck and arm mobility.

The disease is caused by arthritis in the area of the neck, in many cases.  When the cause is not arthritis, it is not specially known what causes it.

The most common types of cervical disc surgery are fusion or disc replacement.

Cervical fusion entails removing the damaged disc and doing a bone graft.  The bone graft is often taken from the hip.

A percentage of spine specialists and surgeons believe the artificial disc replacement method to be a better choice than fusion surgery -- that is, in cases where the patient’s body is healthy in the areas that will support the new disc.  The replacement method is preferred because it restores greatest mobility of the spine, so it can function normally.  The fusion method has a high probability of causing pain in another disc adjacent to the removed disc.  This is then followed by additional surgeries to address the new area of pain.

The need for subsequent surgery can occur in 22 to 25% of fusion procedure patients within 5 to 10 years after the surgery.  About one percent of people undergoing artificial disc replacement experience pain in the adjacent area, necessitating additional surgery.

One hospital study of about 600 surgical patients pointed to a number of problems with fusion surgery that didn’t occur in artificial disc replacement surgery. A surgeon from the study site, from Barnes Jewish Hospital in Washington, reported that a follow up study of patients receiving either spinal fusion or disc replacement showed that 83 percent who had disc replacement had a successful outcome versus 73 percent who had spinal fusion. Success was measured 2 years after surgery, and success was defined by the degree of pain relief the patients experienced 2 years after surgery.

A professional analysis of this study suggests the following advantages of artificial disc replacement over spinal fusion:

  1. No additional pain from bone graft taken from the hip or other part of the body
  2. No use of metal pieces or screws, as needed in some fusion surgery. These foreign objects can contribute to pain.
  3. Fusion surgery creates slight pressure above and below the fusion site. Over the years the pressure causes breakdown of bone material. When this happens another surgery is often needed.
  4. Disc replacement patients usually do not need to wear a neck brace.
  5. Recuperation after surgery is faster for disc replacements.
  6. The pain relief after disc replacement is often immediate, where as the fusion process requires healing time before patients experience pain relief.

It should be noted that the surgeon reporting the results of the study was paid by the manufacture of a specific type of artificial disc.

Some individuals cannot undergo disc replacement surgery; people with more than one diseased disc, and some people with arthritis. The procedure is less proven than fusion; many people’s health insurance doesn’t cover cervical disc surgery using an artificial disc. In any case, the medical profession seems very pro artificial disc replacement.

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