I had a lumbar disc replacement last year that went really well. But now my neck is out so I'm thinking of having the same thing done there. How do these two surgeries compare? Is it easier to put a new disc in the neck or the low back area?
Disc replacement is a wonderful treatment option for the right patient. Lumbar (low back) disc arthroplasty (another name for replacement) has been around longer than cervical (neck) replacements. So there is more data from a larger number of studies on lumbar disc arthroplasty compared with cervical disc arthroplasty.
The uses for these implants are quite a bit different from one area of the spine to another. Neck pain from disc disease seems to respond better to surgery than low back pain does.
Complications from the surgeries are much lower with cervical spine fusion or arthroplasty when compared with the same procedures performed on the lumbar spine. Surgery is often done from the front of the spine in order to avoid trauma or damage to the spinal cord or spinal nerves. But the surgeon still has to deal with the large blood vessels when using the anterior (from the front) approach.
The complication rate linked with torn or punctured blood vessels during anterior spine surgery is much higher in the lumbar region compared with the cervical spine. In general, anterior cervical spine surgery is much less complex than anterior lumbar spine surgery.
Ease of implantation is only one of the many considerations with any device. Long-term durability, rate of adjacent level degeneration, cost, and post-operative recovery are other factors that impact results.
It's natural to make comparisons between cervical and lumbar spine disc replacements. But the cervical disc arthroplasty is much newer on the scene with fewer studies to even look at. It will be some time before further comparisons of this type can be made and any real conclusions drawn.
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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