My sister had a neck fusion back a few years ago. I remember at the time, she thought about having a disc replacement instead. But the surgeon here wasn't doing those back then. Now it's my turn to have neck problems and disc replacement is an option. Which way should I go?
It's been just slightly more than 10 years since the first cervical disc replacements were done on a group of patients in England. These first generation implants had design problems that have since been improved.
Whether to have a cervical spine fusion or disc replacement may depend on several factors. Your diagnosis is important. Currently, there is a limited use for the disc replacements. If you have any spinal deformity, subluxation (partial dislocation) of the vertebra, or issues with alignment, then disc replacement is not usually an option.
Anyone with osteoporosis, a previous history of spinal infection, or spinal instability from trauma isn't usually a good candidate for cervical disc replacement either. Other problems that can put you out of the running for disc replacement include spinal tumors, allergy to metal, lupus, rheumatoid arthritis, or congenital spinal stenosis (narrowing of the spinal canal).
Your age might be a factor. With limited data on how well these implants wear and for how long (durability), surgeons may be reluctant to use them in younger patients. But no one knows for sure because there aren't any studies out yet comparing the rates of success, wear rates, or durability of implants based on age.
Rates of success with spinal fusion rank in the 90th percentile. This means nine out of 10 patients report a good-to-excellent outcome. Surgeons are reluctant to give up that kind of success for a procedure that has had known problems in the past.
Your best bet would be to see your surgeon for an evaluation and recommended treatment plan. Each patient has individual risk factors and issues that must be taken into consideration when making this decision. Your surgeon is the best one to advise you.
Rishi Bhatnagar, et al. Cervical Disc Arthropathy. In Current Orthopaedic Practice. May/June 2010. Vol. 21. No. 3. Pp. 306-309.
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