Cervical Discectomy Fusion vs Cervical Disc Replacement


The cervical spineWhen suffering from a painful spinal condition, our patients all share one goal – to stop the pain. However, when dealing with the cervical spine (the vertebrae in the neck) DISC of Louisiana specializes in two, minimally invasive surgical options – Anterior Cervical Discectomy Fusion vs Cervical Disc Replacement.

In today’s blog post, we’ll discuss these minimally invasive surgical procedures. To make the distinctions perfectly clear, Jeremy R. James, MD, a fellowship-trained spine surgeon who specializes in minimally invasive procedures, to share his knowledge.

Comparing the ACDF and TDR

An Anterior Cervical Discectomy and Fusion (ACDF) and Total Disc Replacement (TDR) are common procedures for treating patients with symptoms related to cervical radiculopathy or a herniated disc in the neck.  Both types of minimally invasive spine surgery have successful outcomes in more than 90 percent of people with single-disc disease.

Patients with cervical myelopathy, degenerative disc disease, spondylolisthesis or spinal stenosis will typically have a fusion rather than disc replacement.

What is an ACDF?

Anterior cervical discectomy fusion vs Cervical Disc ReplacementAnterior means the front of the body. Cervical refers to the vertebrae in the neck. Discectomy is the removal of a disc, and a fusion essentially “joins” together two vertebrae. So, in an ACDF procedure, a damaged disc is removed through a small incision in the front of the neck. The removed disc is replaced by a bone graft and fusion.

“The ACDF is a very common procedure,” says Dr. James, “and it can be performed on multiple levels of the spine. However, the procedure is not without potential downsides.” Dr. James explained that after having an ACDF, there is an elevated chance patients may need future surgery on the adjacent levels.

“The levels of the spine that were fused lose their ability to flex and bend,” says James, “The strain affects neighboring levels, and the increased stress means those discs may degenerate at a faster rate.”

What is a Cervical Total Disc Replacement?

Anterior Cervical Discectomy Fusion vs Cervical Disc ReplacementA TDR is similar to an ACDF in that the problematic disc is removed to decompress the spinal cord and nerve roots. However, instead of a fusing two discs together, an artificial disc is placed into the empty disc space.  The incision is closed using absorbable sutures (stitches) under the skin. The skin is then carefully closed with sutures that minimize any scarring.

“Since the discs are not fused, the patient maintains a more natural range of motion at the replacement site. This creates less stress on the remaining vertebra,” says Dr. James, “Less stress on the neighboring vertebra means a decreased risk of adjacent level disease. This is a big advantage over a fusion, which, unfortunately, increases the stress on the discs above and below the fused discs.”

Should I get a TDR or ACDF?

It depends. A cervical disc replacement surgery is recommended for adults, typically between the ages 21-67, who don’t have arthritis and whose disease only affects one or two levels of the spine. For example, Dr. James recently treated a 37-year-old patient who was a perfect candidate, and responded beautifully to a cervical total disc replacement.

“The patient presented with left arm pain and a large disc herniation,” Dr. James says. “I performed the TDR, and he had instant relief from his nagging arm pain and experienced a full return of his arm strength.”

Who is Not Eligible for a TDR?

Unfortunately, many conditions may mean patients are not good candidates for a cervical TDR:  isolated axial neck pain, ankylosing spondylitis or pregnancy, autoimmune disease, severe arthritis, spinal infection, metal allergies, severe osteoporosis/osteopenia, active malignancy, metabolic bone disease, trauma, instability, three or more discs requiring treatment, insulin dependent diabetes, mellitus or morbid obesity, among them.

What to Expect

Whether you undergo an ACDF or a TDR at DISC of LA, you can be sure that you’re in expert hands, and that you’ll recover quickly compared to traditional, open spine surgery. After the minimally invasive surgeries, most patients return home without a long hospital stay. The incisions are so small they can be covered by a Band-Aid. Best of all, in many cases, the pain relief is instant.

Anterior Cervical Discectomy Fusion vs Cervical Disc Replacement

Which Option is Right for You?

Many of our patients say they suffered needlessly for years from the pain caused by cervical spinal pain. Most of our patients thought cervical spinal pain was just a part of their life. After having their condition treated at DISC of Louisiana, our patients took the necessary steps to find permanent relief.

Always consult your doctor if you have pain that does not improve immediately. If chronic pain from a spinal condition is ruining your quality of life, contact DISC of Louisiana today to learn more about your treatment options. DISC of Louisiana has convenient locations throughout the Greater New Orleans area.

New Orleans | Hammond | Slidell | Covington | Metairie | Baton Rouge | Gonazles

This site is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Through this site and links to other sites, DISC of Louisiana provides general information for educational purposes only. The information provided in this site, or through links to other sites, is not a substitute for medical or professional care. You should not use this information in place of a visit, call consultation or the advice of your physician or other healthcare provider. DISC of Louisiana is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this site.

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