Artificial Disk Replacement in the Neck

Sunday February 18, 2007

...To replace or not to replace?

One drawback of fusion surgery for disk problems is that the particular vertebral segment where the surgery occurs loses the ability to move. There are consequences that sometimes arise from this that can actually cause neck pain, because the joints above and below have to make up for the deficit.

Artifical disk replacement is a new type of spine surgery that has the potential benefit of preserving motion. However, the procedure (and the hardware) is still quite new --- the medical literature is lacking in definitive support for the ability of disk repalcement to provide this stated benefit, especially in the long term.

A study published in Spine Journal in November 2006 looked at 54 patients with a total of 77 artificial disks, (ProDisc C) to see, if indeed, motion had been preserved after neck surgery. By the way, artificial disk replacement in the neck area is a much more uncharted territory than in the low back area. Based on signs of bone hardening (ossification), as well as the tell-tale sign of spontaneous fusion, researchers were able to get an initial, general idea of just how well this type of surgery might be at preserving motion in the long run. About half of the people studied had some fusion (yes, similar to what happens in spinal fusion surgery). Unfortunately, the goal of preserving motion that is hoped for in total disk replacement is sacrificed where there is fusion. This suggests to researchers that the disc replacement may not provide the benefits for which its proponents hope.

The researchers only looked at these patients one year out, and suggested that over the long haul the rate of spontaneous fusion may be much higher, further negating a main benefit of disk replacement in the neck, motion preservation.

Artificial Disk Replacement in the Neck

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