What is Fusion vs. Artificial Disc?

I’m often asked by patients whether they should go forward and get a procedure that is a fusion procedure in their neck where the bones are married to each other with a cage and a plate or if they should go for a more attractive option like an artificial disc where the movement and integrity between the two vertebral bodies is still maintained.

These two procedures can be confusing and it can make it very hard for you to decide which one is better.

Traditionally, a spinal fusion has been recommended over the last several decades.

It’s a proven technique that’s been around for ages.

We know people do well with it. Lots of data that backs it.

The negative of this is that you will lose some range of motion in your neck.

Every level that you fuse, you’re going to lose approximately 6 degrees range of motion.

That may or may not be a big deal but it adds up if you have multiple levels of cervical fusion.

The other problem with a cervical fusion is that it puts stress on the levels above and the levels below due to a lever arm and it leads to unfortunately more surgery down the road.

How frequently? 20% chance over the next 20 years you may need additional surgery.

On the other hand, we have the new kit on the the block which is the artificial disc.

The benefits of an artificial disc are that you get to keep the range of motion.

You see how there’s the gliding motion that is preserved compared to a cervical fusion where the bones can no longer move.

And many people say it avoids the adjacent level breakdown above and below.

So the negative with an artificial disc… It’s been around since the 2000s.

We don’t have much data on it.

We are starting to develop and gather data on it but we don’t know what these are going to perform 40, 50, 60 years down the road.

It’s not necessarily right for everybody.

It is not a good option for a person who has a lot of bony arthritis.

If there’s a lot of bony arthritis and the bones have already collapsed on each other and stuck to each other, you’re not going to be able to put an artificial disc in between them and maintain that gliding motion and that mobility.

So, for severe arthritis, an artificial disc is not a good option.

So, it comes down to what your condition is.

If it’s a soft disc herniation, you value your range of motion, an artificial disc is a good option for you.

On the other hand, if you’re having a lot of arthritis that requires a lot of bony drilling, then you may have no choice but to go for a cervical fusion which is a tried and tested model.

The question of artificial disc versus a cervical fusion comes up every day in my office and it’s important to sit and discuss the pros and cons of each one of these options so that we make the right decision out of the gates.

My goal is that you shouldn’t need to get another surgery and if we make the right decision, we’re able to avoid further surgeries down the road.