Fusion or Replacement: Which Is Best for Your Cervical Spine?

Pain in the neck and cervical spine is one of the most common complaints by American patients. Around 27 out of 1,000 people will experience neck pain at a level that interferes with their daily lives. When you experience cervical distress, basic activities like eating, sleeping, and watching TV can be severely uncomfortable. This is why doctors work through a variety of treatments to help their patients heal.

When you first start receiving treatment for pain in your cervical spine, your doctor will likely start with non-invasive options. These include medications, physical therapy, stretching, and hot and cold treatments. If non-invasive options don’t work, your doctor might recommend surgery. You could either be a candidate for spinal fusion or artificial disc replacement.

The choice between fusion and cervical disc replacement is crucial because it can impact your recovery and long-term mobility. Knowing your options can help you make an informed decision that is good for your health. Learn more about the differences between the two and why more people are opting for artificial disc replacement. While not all patients are candidates for a cervical artificial disc replacement, more and more people are now undergoing the procedure as a result of advancements in technology and surgical techniques.

Spinal Fusion: A Closer Look

Both spinal fusion and artificial disc replacement address pain caused by worn-out or broken discs in between your vertebrae. These discs are supposed to act as cushions and shock absorbers. When they become damaged, the discs can get pushed into your spinal canal and pinch nerves, causing severe pain and even tingling or numbness down your arms.

With cervical spinal fusion, your surgeon removes the damaged disc and then uses plates and screws to fuse the two vertebrae together. This usually involves placing a spacer or cage filled with bone graft into the former disc space. The plate and screws prevent your vertebrae from moving, preventing further pain.

What are the benefits of spinal fusion?

For decades, spinal fusion was really the only operation for addressing cervical pain. This option has a long track record that has helped many patients. There are still some instances when doctors recommend fusion over artificial disc replacement.

What are the drawbacks and potential complications of spinal fusion?

Technological development has led to significant advancements in modern surgery, which renders fusion unnecessary in many instances. Spinal fusion can be considered more invasive than disc replacement, which means it comes longer recovery time and some long term consequences. While it can reduce your pain levels, it limits your range of motion. You might not be able to turn your neck or bend your body as easily because your vertebrae are fused. This can place more stress on the other discs and potentially lead to problems and pain in the future.

Artificial Disc Replacement: A Top Alternative

Artificial disc replacement (ADR) is made possible by the development of small disc implants that simulate the ones found naturally in your body. These discs are made of a variety of high tech plastics and metal alloys that are often used in implants within the body. These same materials have been safely used for artificial knee and hip replacements for decades with excellent results. Through ADR, your doctor removes the damaged disc and then replaces it with one of these artificial models. The vertebrae don’t need to be fused and the new disc acts just like your original one.

What are the advantages of artificial disc replacement?

ADR is an increasingly popular operation for patients with cervical pain, as it is less invasive than fusion and can be completed as an outpatient procedure often at an ambulatory surgery center. This means you don’t have to go through the stress and cost of a hospital stay. The incision is usually only about an inch long and the procedure is usually completed in about an hour.

ADR also drives better results. Not only can you enjoy reduced pain levels, but you can maintain your neck mobility after the operation heals.

What are the potential risks and complications of disc replacement?

Every operation comes with risks and potential complications. There is always a risk of infection with any surgery. There is always a possibility that pain is not completely relieved or that you may have some symptoms that don’t improve. However, the chances of these potential complications are extremely low. One study of 293 patients published through the National Library of Medicine found that less than 3.7% of cases experienced complications after surgery.

How does cervical disc replacement differ from fusion?

The main difference between fusion and cervical disc replacement is the focus on mobility. Adults have 24 vertebrae that allow them to bend and twist comfortably. When these vertebrae are fused, it becomes harder to move. Depending on where your damaged disc is located in your cervical spine, you might have a harder time turning your head or looking down to tie your shoes.

With ADR, the artificial disc simulates the natural ones found in your body. This means you can regain or keep your mobility through stretching and physical therapy exercises. Many elite athletes seek out disc replacement instead of fusion and are eventually able to return to the court or the field. A football player in the NFL needs to be able to turn his head quickly throughout the game to follow the ball. They need their full range of motion and have to move without pain to be successful.

Spinal disc replacement significantly outperforms spinal fusion in terms of mobility. Patients can move naturally and without pain once they complete the recovery process. However, it is also important to look at the long-term outcomes of both procedures.

Both fusion and ADR are designed to be long-term solutions. In one study of patients who underwent spinal fusion, success rates ranged from 85% to 95% over a decade. Few patients experienced additional degeneration or needed additional surgery to address cervical pain. ADR has similar success rates based on the literature but in many cases better outcomes are achieved. More than 90% of patients successfully recover and enjoy lower pain levels and improved range of motion. The artificial discs are designed to last several decades and most likely, the rest of your life.

Cervical fusion and ADR have similar recovery rates, but they differ in how quickly you can return to normal activities and sports. With a fusion, the spinal bones need to grow solidly together before you can return to labor intensive work or recreational activities. This can typically take up to 3 months and sometimes is longer if multiple discs require surgery. Most patients are placed into a rigid collar after surgery to help with the bone healing process. The collar is meant to restrict neck movement, and can make the recovery of neck range of motion a very lengthy process. With ADR on the other hand, you can expect to return to normal movement levels much faster, often within six weeks. There is no need for a rigid collar because the implants are designed to move right away. Many surgeons provide ADR patients with only a soft cervical collar after surgery just to wear as needed for comfort. For these reasons, ADR is considered a less invasive operation, which means your recovery process could be faster.

Why Choose Artificial Disc Replacement?

Through this guide, you can see that there are a lot of factors to consider when choosing between fusion and artificial disc replacement. You will need to review the outcomes of the operations, their risks, and their recovery times. The best decision is ultimately up to you. However, more patients are increasingly opting for disc replacement because it is less invasive and has better results. If you have a more active lifestyle and want to restore your range of motion, ask your doctor about disc replacement.

What Makes Spinal Surgeon K. Brandon Strenge, M.D. a Top Choice for Cervical Disc Replacement?

If you live with cervical pain that is interfering with your ability to enjoy life, consider requesting a consultation with Dr. K Brandon Strenge in Paducah, Kentucky. Dr. Strenge has been a practicing surgeon since he completed his Orthopedic Surgery Residency at the Southern Illinois School of Medicine in 2008. He completed a spine fellowship at the Spinal Institute at Santa Monica in 2009 and has since brought his skills and experience to Paducah. Patients travel from across the country to meet with him. Dr. Strenge has led or assisted with more than 16 clinical trials related to spinal fusion and disc replacement. This makes him a leader in the field.

You don’t have to live with neck pain. Request a consultation with Dr. Strenge and take the first steps toward regaining your mobility and feeling comfortable again.

FREQUENTLY ASKED QUESTIONS

What is the cost difference between cervical fusion and disc replacement?

Surgical costs vary by state and by doctor. Using Kentucky as an example, the average cost for spinal fusion is around $25,000. In most states, the cost ranges from $25,000 to $30,000. The cost of artificial disc replacement is similar. In Louisville, Kentucky, the average cost for ADR is a little more than $26,000. In more expensive cities, you could pay more than $50,000 for ADR before you calculate your insurance coverage. 

Does insurance typically cover these procedures?

Severe neck and back pain is considered a quality of life issue, which means both fusion and ADR are covered by most health insurance plans. This is an essential procedure and the patient cannot live comfortably or work without the operation. If you have health insurance, contact your provider to confirm that these operations are covered.

What is the recovery timeline for each option?

Both spinal fusion and ADR have different recovery times. It will take around 6 weeks for your spine to heal from ADR and up to six months to completely recover from a fusion operation. During this time, you will have regular appointments with your doctor so they can clear you to return to work and lift heavy objects again.

Are there age restrictions for disc replacement?

Yes, there can be. Your doctor wants to make sure you have the best chance of making a full recovery and that the implants function appropriately in your neck. As people age, the bone quality can become weak, which can make disc replacement a poor surgical choice. This is why they often limit candidates to people who are between the ages of 18 and 60. Of course, there may be exceptions to this age limit if you are in good health and have strong bones.

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