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Back Pain Health Center

Cervical Disc Surgery: Disc Replacement or Fusion?

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The vast majority of people -- more than 90% -- with pain from cervical disc disease will get better on their own over time with simple, conservative treatments. Surgery, however, may help if other treatments fail or if symptoms worsen.

Cervical disc disease is caused by an abnormality in one or more discs -- the cushions -- that lie between the neck bones (vertebrae). When a disc is damaged -- due to arthritis or an unknown cause -- it can lead to neck pain from inflammation or muscle spasm. In severe cases, pain and numbness can occur in the arms from pressure on the cervical nerve roots.

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Surgery for cervical disc disease typically involves removing the disc that is pinching the nerve or pressing on the spinal cord. This surgery is called a discectomy. Depending on where the disc is located, the surgeon can remove it through a small incision either in the front (anterior discectomy) or back (posterior discectomy) of the neck while you are under anesthesia. A similar technique, microdiscectomy, removes the disc through a smaller incision using a microscope or other magnifying device.

To close the space that's left when the disc is removed and restore the spine to its original height, patients have two options:

  • Artificial cervical disc replacement
  • Cervical fusion

In 2007, the FDA approved the first artificial disc, the Prestige Cervical disc, which looks and moves much like the real thing but is made of metal. Ongoing research has shown that the artificial disc can improve neck and arm pain as safely and effectively as cervical fusion while allowing for range of motion that is as good or better than with cervical fusion.  People who get the artificial disc are often able to return to work more quickly as well. The surgery to replace the disc, however, does take longer and can lead to more blood loss than with cervical fusion.  People who get an artificial disc can always opt for cervical fusion later. But if a patient has cervical fusion first, it's not possible to later put an artificial disc in the same spot.

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