Disc Replacement Versus Fusion

"Which Is Better Cervical Fusion Or Disc Replacement?"
by Dr. Benjamin Geddes

It's a good question. I mean, at the end of the day, all these questions really come down to the patient and the individual patient. And there are pros and cons to each. And there are lots of patient factors which I would discuss with the person. Go through in terms of age, demographics. What your goals are for the treatment and what type of pathology you have, bone quality, etc. There's a lot of things to consider.

But certainly in a younger patient, a great option, and even in some older patients, a great option is to preserve motion. You know, the difference at the end of the day is with the fusion it is just as it says. The goal is to weave two bones or three bones into one and you lose the motion through that space. Whereas a replacement or we call an arthroplasty is where you replace the disk material with instead of a block, you replace it with a device that allows for motion.

And just I think in a lot of ways, visually, it makes sense to look at it. And basically, this is a model of the spine. And you can see here that these implants allow for motion flexion, extension, and real side to side bending, which is mostly what you're going to see in this part of the spine. And essentially there are two components. There's a top component here that has a spiritual or partial sphere on it and it meets with this lower portion down here that allows for that motion.

There are all different types of implants and they are made of all different types of material. Some are made of a plastic called polyethylene, and some of them are made of metal or a combination thereof. But the goal of all of them is really to grow into the bone and allow for motion of the neck. And that's sort of counter to fusion, which is a fusion, the approach and the removal of the bone and the disc material is all very similar. But in this case, you put a spacer into that space, and then you put a plate and screws typically over top of it, just to keep from there being too much motion in this case so that it can heal itself in this bone can weave together. So those are your two options. Ultimately, arthroplasty is the goal which is to preserve the normal mechanics of the neck.

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Dr. Benjamin Geddes