Disc Replacement vs Fusion

"Which Is Better Cervical Fusion Or Disc Replacement?"
by Dr. J. Alex Sielatycki

When you're treating a herniated disc, looking at fusion versus disk replacement, there's a lot of things that need to be considered. And some patients may not qualify for disc replacement based on their anatomy, based on bone quality, and their underlying condition.

So if somebody has an infection in their neck, that is an indication that you should not have a disc replacement. That said, when we've compared apples to apples or compared patients that are similar and can have either a fusion or disc replacement, this is one of the most widely studied areas in spine surgery.

There are hundreds of publications and hundreds of papers in the scientific literature comparing disc replacement versus fusion, and they're well-done studies that have now tracked patients for a long time over the course of 10, 12, even 15 years. And the longer we look at this, the more clear it becomes that disk replacement does seem to be a better option than fusion for a good majority of patients. The research that we have does show that with disc replacement compared to fusion, patients have a better pain score. So lower neck and arm pain, long term, lower risk of recuperation after surgery and in many cases earlier recovery earlier returned to work and better patient satisfaction.

So if you have an option for either disc replacement or fusion, I would say in general disc replacement is going to be the better choice. That said, there is one caveat to that, and that is that disk replacement is a little bit more of a technically challenging operation to do than a fusion. So it's a little bit less forgiving.

So if you're having a disc replacement done, you want to make sure your surgeon is very experienced in those and has done a lot of them and has good results in disc replacement because if you have one done by a surgeon who's not familiar with the technique and not familiar with the implant and hasn't done any of them, there may be some subtle things done or not done that would leave you with residual pain, whereas one who's had a lot of experience with those just replacements, you're going to probably get a better result.

So a little bit of it is surgeon dependent and technique dependent, but all things being equal disc replacement versus fusion, I think the easy answer is that disk replacement is better.

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Dr. J. Alex Sielatycki