Cervical disc replacement surgery is a new option for people with pain in the neck and/or arm due to arthritis or degenerative disc disease. Unlike cervical disc fusion surgery, which cements vertebrae together, cervical disc replacement swaps out the problematic disc for an artificial one. This shortens post-operative recovery time, preserves mobility in the spine, and still allows for spinal fusion surgery down the line, if needed. Wondering whether cervical disc replacement is right for you? Here, Duke spine surgeon Deb A. Bhowmick, MD, answers your questions.
What kind of pain does cervical disc replacement relieve?
Cervical disc replacement targets age-related wear and tear in the neck. Like much of the spine, the cervical spine -- the section between the top of your shoulders and the base of your skull -- consists of a stack of bones called vertebrae that are separated by shock-absorbing pads called discs.
Neck arthritis, also known as cervical spondylosis, can develop as the joints and discs wear down over time, sometimes causing rocklike growths called bone spurs. Or degenerative disc disease can develop when discs in the cervical spine move out of place, bulge, or lose their shape. Some people have both conditions. These changes in the spine can put pressure on nerves, causing pain and weakness. They can also contribute to other spine conditions like cervical radiculopathy, commonly known as a pinched nerve, which causes shooting arm pain.
Is cervical disc replacement better than cervical disc fusion?
Cervical disc replacement (also known as cervical disc arthroplasty) is relatively new compared to cervical disc fusion, which has been around for decades. While both are effective treatments, cervical disc replacement has some advantages.
Both surgeries require an incision in the front of the neck and removal of the material that's causing problems, such as a bone spur or a bulging disc. The difference is in what your surgeon does next.
During cervical disc fusion, surgeons implant bone grafts and/or plates and screws to immobilize a short section of the spine. “The disadvantage is that you can no longer move that segment of the spine, although most people don’t notice a huge difference in function,” Dr. Bhowmick said. While the fused section can never redevelop arthritis, there is a higher risk of developing arthritis in the sections above and below because they must work harder to compensate for the immobilized segment.
During cervical disc replacement, the disc causing pain is removed and replaced with an artificial disc that allows the joint to continue normal movement. As a result, the segments above and below that area don't have to work harder. While it is possible for arthritis to develop where the artificial disc was placed, it is uncommon, Dr. Bhowmick said.
A shorter recovery is another major advantage of cervical disc replacement. After cervical disc replacement surgery, neck movement is encouraged, which means you can return to work and other activities after two to six weeks. People who undergo a cervical disc fusion must avoid lifting heavy objects and restrict some neck movement for up to three months.
“The final advantage is that you haven't burned any bridges,” said Dr. Bhowmick. “If you’re still having pain down the line, you can always fuse that segment of spine.”
How successful is cervical disc replacement?
“There's mounting evidence that cervical disc replacement is superior to fusion, in the right patients,” said Dr. Bhowmick. Up to 95% of people with shooting arm pain – usually caused by a disc herniation -- experience a positive result within six weeks of the surgery.1 Research shows people who undergo disc replacement surgery are also less likely to need another operation within five years compared with people who get cervical disc fusion.2
Am I a candidate for cervical disc replacement?
Cervical disc replacement may be an option for you if:
- You experience shooting arm pain or neck pain that is associated with a disc problem in your cervical spine.
- Only one or two levels of your cervical spine are affected.
- Non-surgical treatments have failed to relieve your pain.
What is my next step?
If you’re interested in learning more about cervical disc replacement to relieve your neck and arm pain, Dr. Bhowmick recommends making an appointment with a spine surgeon at Duke. “The benefit of coming to a place like Duke is that we offer all the different surgical options, and you and your physician can make an informed decision,” Dr. Bhowmick said.
