The vertebrae, ligaments, and muscles that comprise the cervical spine perform an invaluable function. Together, they allow our heads to be supported, giving our necks the freedom of movement. When neck pain, reduced range of motion, and neurological symptoms prevent us from freely moving our head and neck, it can be extremely frustrating and make the things we enjoy, less pleasurable.
At EmergeOrtho—Triangle Region, our fellowship trained back, neck, and spine doctors routinely help patients navigate cervical spine conditions. While we are committed to utilizing conservative treatment methods whenever possible, we also offer surgical options such as cervical spinal fusion and disc replacement. Our ultimate goal is to help each patient Emerge Stronger. Healthier. Better.
Neurological Symptoms: When You Have More Than Neck Pain
Many people have neck pain due to arthritis, disc degeneration, and other similar causes. But, often these conditions can be addressed nonsurgically. Isolated neck pain resulting from disc degeneration doesn’t respond well to surgery. However, when neck pain is accompanied by a neurological issue, this may indicate the need for surgical intervention. Neurological symptoms can be triggered by:
- Pinched nerves (due to bone spurs)
- Herniated disc
- Calcium deposits
These abnormalities may lead to scapular, shoulder, arm, and lower elbow pain with weakness and numbness extending down to the hand called radiculopathy. Sometimes they can cause loss of coordination, clumsiness, difficulty with fine motor tasks, and gait instability called myelopathy. When this happens, surgery may be recommended.
A Closer Look at How Disc Degeneration Impacts Neurological Issues
Cervical disc degeneration commonly happens to people starting in their 30s and 40s. In addition to wear and tear, disc degeneration can be the result of the aging process, genetics, and environmental factors (lifestyle, trauma, injury, etc.) Because of the stress placed on the cervical spine over time, the gelatin-like center of the cervical disc degenerates. In turn, the space between the vertebrae narrows, putting further stress on the joints of the spine.
Once disc degeneration causes compression and narrowing of the space for the spinal cord and nerves, that is when neurological issues such as radiculopathy and myelopathy.
The following factors may indicate that cervical spinal fusion or disc replacement surgery is needed to resolve your neurologic symptoms:
- Conservative treatment methods have failed to address neurologic issues.
- Progressive neurological deficits occur (increased weakness and pain.)
- Myelopathy: gait disturbance, clumsiness, weakness, lack of coordination worsen.
Cervical Spinal Fusion vs. Disc Replacement Surgery
When conservative treatment methods such as pain medication, physical therapy, traction, epidural steroid injections, and activity modification fail to reduce cervical spine and upper extremity neurological signs and symptoms, your physician may recommend surgery—depending on the pathology.
While there are several types of surgery to address neurological symptoms, two of the most common include spinal fusion and cervical disc replacement.
All disc replacement surgeries are candidates for discectomy fusion, however, not all discectomy fusions are candidates for disc replacement. Some patients may have arthritis that is too severe, the degeneration disease has progressed too far, or their anatomy is not conducive to disc replacement surgery.
How Spinal Fusion Works
Cervical spinal fusion and lumbar spinal fusion offer a method of alleviating pain by decompression nerves and fusing together two or more vertebrae in the spine. In the case of cervical spinal fusion, we are referring to the neck; lumbar spinal fusion refers to the low back.
Your surgeon may use a bone graft and/or cage (artificial spacer) to fill in space where the disc has been removed. These plate and screws are literally fused on a vertebrae to another creating a single, solid bone. Fusing the vertebrae together restricts movement. In doing so, pain is relieved from the absence of degenerative discs rubbing together; however, some flexibility in the spine is compromised.
Once you have had a successful fusion, you never have to worry about those particular discs again. However, you do have to be aware of degeneration that may occur to the neighboring discs.
Activity restrictions following spinal fusion are about three months.
How Cervical Disc Replacement Works
Similar to spinal fusion, a disc replacement involves the removal of damaged disc and bone spurs that are replaced with an artificial cervical disc. But, rather than fusing vertebrae together, the artificial disc allows motion to be preserved. At EmergeOrtho-Triangle Region, our spine surgeons utilize multiple FDA approved artificial discs. Artificial discs closely resemble the size and function of a natural disc.
In clinical trials, level-two (two-disc) disease disc replacement was shown to be as good, if not superior, to spinal fusion. The benefits of cervical disc replacement are that:
- You do not have to worry about restricted range of motion.
- Believed by many to reduce adjacent-level stress to surrounding discs.
- No risk of bony nonunion as seen in some fusions
- It comes with fewer post-surgery restrictions.
- It encourages a more rapid recovery and return to work (typically, disc replacement recovery restrictions last around six weeks.)
The potential downside of disc degeneration is that although the artificial replacement is meant to last a lifetime—if it fails—you may have to have a spinal fusion.
If you think disc replacement is right for you, be sure to consult with a provider who has extensive experience in artificial disc replacement. This is because artificial disc replacement is more technically demanding, with a greater risk of error.
Which Spine Surgery is Best For You?
The best way to know whether cervical spinal fusion or artificial disc replacement is best for you is to have a consultation with one of our back, neck, and spine specialists. Because continuous advancements are being made in the design and function of artificial discs, be sure to ask your surgeon about the latest designs—and which one is right for you. Our surgeons have been performing artificial disc replacements since 2005, participating in clinical trials prior to FDA approval.
Our fellowship-trained surgeons are skilled and practiced in spine surgery, offering the latest surgical approaches with a patient-centered focus.
To learn more, schedule an appointment with one of our highly qualified EmergeOrtho–Triangle Region doctors. Or, call us any time at (919) 220-5255.