If you suffer from spine problems that cause neck pain, you don’t have to live with the pain and discomfort. Patients with cervical radiculopathy (radiating neck pain) and other problems of the spinal canal have treatment options. Choosing the right procedure can feel overwhelming, however. In this article, we provide a brief overview of two of the most effective surgeries for problems affecting the spinal cord and nerves in the neck – cervical fusion and artificial disc replacement.
First, let’s take a quick look at the anatomy of the human spine. The cervical spine or neck has 7 vertebrae (spine bones), the thoracic spine or mid-back has 12, and the lumbar spine or lower back has 5 vertebrae. Also, there are 5 sacral vertebrae that are fused together plus the coccyx or tailbone. The spine forms a protective tunnel for the spinal column which encloses the spinal cord. When the space between the vertebrae becomes narrowed or something like a bone spur presses on the spinal nerve or nerve roots, it can cause symptoms like pain, weakness, and numbness. The problem can be diagnosed with imaging tests like a CT scan. The signs and symptoms sometimes respond to non-surgical treatments like steroid injections, cervical traction, cervical collar, or physical therapy. However, sometimes disc surgery is recommended for treatment of cervical radiculopathy, disk herniation, pinched nerve, and other problems.
Anterior cervical discectomy and fusion (in short, ACDF) has been performed safely and effectively for decades. The procedure involves removal of the damaged or herniated disc (bulging disc). A bone graft is then applied to the area to encourage bone growth. The fusion of the vertebrae eliminates movement. The incision is made on the front of the neck. Recovery is pretty straightforward and usually takes a month. However, the vertebrae take 3 months to fully fuse.
As ACDF is a well-established procedure that has been performed for decades, spine surgeons are experienced in it and understand its long-term effectiveness. Also, it has a good safety record and is suitable for many different kinds of cervical spine problems, including people who have had neck surgery in the past.
Also called total disc arthroplasty, this procedure involves removing and replacing a damaged cervical disk with an artificial one. The incision is made on the side of the neck. Recovery usually takes 4-6 weeks.
The main advantage of artificial disc replacement is there’s no bone graft involved, so there’s no risk of non-union. Also, an artificial disc that is properly sized and placed permits motion, unlike a cervical fusion procedure, thereby ensuring more natural mechanics of the spine. Recovery is quicker from an artificial disc replacement because you don’t have to wait for the fusion to occur.
When comparing cervical fusion and artificial disc, one procedure is not better than the other. Both procedures have good comparable long-term outcomes. The choice depends on the specific problem with your cervical spine, your health status, as well as what your physical examination and computed tomography CT or other imaging studies show. It’s best to go with the medical advice you receive at the spine centre where spine specialists will analyse your problem and recommend the best treatment option.