Dr. Jay Jagannathan: Disk replacement is alternative to spinal fusion for active adults

Spine issues are common among older adults, and many people are looking for the best treatment options that will allow them to stay active comfortably for years to come.

When seeing a spine surgeon, one fear many people have is being told they will need a spinal fusion. Cervical spinal fusion — which connects two or more vertebrae in your spine to increase stability, corrects deformities or reduces pain — is a time-tested technique that can be extremely effective in restoring spinal alignment and helping with arm pain from a pinched disk, but the major drawback is it usually permanently affects range of motion in the neck.

Additionally, there is evidence that fusing a normally mobile segment of the spine can put stress on levels above and below the fusion, resulting in arthritis over time, leading to what is called “adjacent level disease”.

This is particularly of concern in younger patients, as adjacent level disease commonly begins to manifest between two and five years post-fusion and tends to progress as you grow older.

What is Cervical Artificial Disk Replacement?

The concerns outlined above led to the arrival of another option: cervical artificial disks.

In disk replacement, rather than fusing two adjacent segments of the spine, an artificial disk is placed, to mimic the motion of the normal spine. The theoretical advantage of this is that neck motion is preserved. Since mobility remains normal, this can also potentially lower the incidence of adjacent level disease.

Disk replacement is typically performed through an incision in the front of the neck.

Using dissection, the neck muscles are retracted and the damaged (or degenerated) disk is removed. Bone spurs or disks pushing on a nerve also are cleaned out, decompressing a nerve which may have been pinched. Finally, once the area has been satisfactorily decompressed, the artificial disk is placed into the disk space.

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