Alternative to Spinal Fusion: Cervical Disc Replacement

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A cervical artificial disc is designed to replace an intervertebral disc damaged by neck disorders such as degenerative disc disease or disc herniation.  Cervical disc replacement surgery is an alternative to spinal fusion in carefully selected patients.

Spinal fusion fuses or permanently joins two vertebral bodies and eliminates movement at that level.  An artificial disc allows movement by mimicking the properties of the human intervertebral disc.   In theory, disc replacement protects other discs by sharing the stress during movement.  In addition, the cervical spine is stabilized, mobility is maintained, and lost disc height is restored.

There are different artificial disc designs.  Implant composition includes hard (metal) and soft (nonmetal) materials.

• Metal, such as stainless steel
• Nonmetal, such as polyethylene
• Combination

An artificial disc replaces the entire intervertebral disc; the annulus fibrosus, nucleus pulposus, and usually the endplates -- depending on the type of device.

When Spine Surgery May Be Recommended

Most patients with a cervical problem do not need spine surgery, such as fusion and instrumentation.  Some reasons why cervical spine surgery may be considered include:

• Nonsurgical treatments do not help resolve pain and other symptoms. These treatments include medication, spinal injections, and physical therapy.
• Neurological symptoms are progressive, worsening, and involve the arms and/or legs.  These symptoms include numbness, tingling, and/or weakness.

• Problems with balance, trouble walking.  

• General health is good.

Patient Selection Important

Since cervical artificial discs are not indicated to treat all spinal disorders or patients, evaluation by a skilled spinal surgeon is essential.  If an artificial disc appears suitable, the surgeon will explain the type of device to be implanted. Along with information about the artificial disc, patients should ask about the benefits and risks of the device and procedure.

Possible Risks and Complications

Any surgical or medical procedure carries with it inherent risks. The surgeon explains potential risks and benefits to individual patients, since risks vary by patient.

Conclusion

Not all patients with neck problems will require surgery, but cervical disc replacement has provided pain relief for many people with moderate to severe chronic neck pain. Appropriate candidates are usually those in good health who have not derived pain relief from more conservative treatments.