From the Guidelines
No, cervical fusion and cervical disc replacement are not the same procedures. Cervical fusion permanently joins two or more vertebrae in the neck using bone grafts and hardware like plates and screws, eliminating motion between those segments to reduce pain. In contrast, cervical disc replacement involves removing the damaged disc and replacing it with an artificial disc device that preserves motion at that level. The key difference is that fusion eliminates movement between vertebrae while disc replacement aims to maintain normal neck motion.
Key Differences
- Fusion may lead to increased stress on adjacent segments over time, potentially causing adjacent segment disease, while disc replacement attempts to prevent this complication by preserving more natural neck biomechanics.
- Both procedures address similar conditions like herniated discs or degenerative disc disease, but the appropriate choice depends on specific patient factors including age, anatomy, number of levels affected, and surgeon expertise.
Evidence Comparison
Although the provided evidence 1 primarily discusses lumbar spine procedures, the principles of fusion and disc replacement can be applied to cervical procedures as well. The study found that total disc replacement significantly improved pain and patient satisfaction, reduced reoperation rate and operation time, shortened duration of hospital admission, and decreased post-surgical complications compared with lumbar spine fusion.
Considerations for Cervical Procedures
- The choice between cervical fusion and disc replacement should be based on individual patient needs and factors, considering the potential benefits and risks of each procedure.
- It is essential to consult with a qualified healthcare professional to determine the most suitable treatment option for specific conditions and circumstances.
From the Research
Cervical Fusion vs Cervical Disc Replacement
- Cervical fusion, also known as anterior cervical discectomy and fusion (ACDF), is a surgical procedure that involves removing a damaged disc in the cervical spine and fusing the surrounding vertebrae together using a bone graft or other material 2.
- Cervical disc replacement, on the other hand, is a surgical procedure that involves replacing a damaged disc with an artificial one, allowing for more natural movement and flexibility in the spine 2, 3.
- The main difference between the two procedures is that cervical fusion results in the loss of motion at the affected level, while cervical disc replacement aims to preserve motion and reduce the risk of adjacent segment disease 2, 4.
Clinical Outcomes
- Studies have shown that both cervical fusion and disc replacement can be effective in reducing pain and improving function in patients with cervical degenerative disc disease 2, 5, 3.
- However, some studies have found that cervical disc replacement may be associated with better preservation of motion and reduced risk of adjacent segment disease compared to cervical fusion 2, 3.
- A study comparing the outcomes of two-level cervical arthroplasty and anterior fusion found that clinical outcomes were similar between the two groups, but the arthroplasty group had increased range of motion at 24 months post-operation 3.
Patient Preferences
- A study examining patient preferences for autograft versus graft substitutes in ACDF found that patients preferred graft substitutes due to reduced pain and faster recovery times 6.
- Another study found that patients who underwent cervical disc replacement reported better recovery and less postoperative pain compared to those who underwent ACDF with autograft 6.