A common concern that patients have when discussing spinal surgery is whether they will lose mobility and function after the procedure. This question frequently comes from fear arising from urban myth or historic outcomes from older surgical techniques.
In modern spinal surgery, the operations are designed to minimize trauma to normal, healthy tissues and to preserve as much tissue and function as possible. The enormous benefit to modern technology and instrumentation is that it allows spinal surgeons to heal each injured or abnormal disc individually in each specific level of the spine. This is accomplished with precisely engineered instruments that can stabilize one segment at a time with the least impact on adjacent levels.
In addition to innovative instrumentation, we now have the development of disc replacements that can actually preserve motion within the spine. It used to be when a spinal disc was injured, resulting in pain and dysfunction, the only solution was to fuse the area to provide stability, but restrict movement in that area. Artificial discs replace the injured disc and preserve and/or restore the motion! This enables the patient to not only have a better surgical outcome, but again, it places less stress on the adjacent structures. In these cases, the patients usually do not lose any motion and maintain a more natural function of the neck.
Motion preserving operations, or disc replacements, are ideal for people that suffer from a disc degeneration or disc herniation that is causing significant neck or arm pain. Unfortunately, if the discs are too degenerated or if there is instability/severe postural misalignment, then a spinal fusion may be the best option to provide stability.
The surgical specialist uses x-rays, MRIs, physical examination, and other diagnostic tools to make the decision about whether a patient is an appropriate candidate for disc replacement or fusion. One of the great advances that we can offer today is a combined therapy where a fusion is performed at the level adjacent to the artificial disc. This may be appropriate if more than one level needs to be treated and the disc replacement or fusion is not the right answer for all of the levels. A hybrid construct can be extremely successful in eliminating the pain, solving the patient’s problems, while preserving maximum motion. This is the ideal case for the majority of the patients. In fact, I had this done to my own neck where I had one level fused and two levels replaced to solve a chronic problem while preserving the motion necessary for me to continue functioning as a spinal surgeon.
When seeking evaluation for neck pain, find a spinal surgeon who is well versed in both fusion and disc replacement procedures so that they may help you make the best choice for your condition!
Dr. Thomas Schuler is a world-renowned, double board certified spine surgeon; trained in both neurosurgery and orthopedic surgery of the spine. He founded Virginia Spine Institute in 1992 and is a recognized international leader in the treatment of neck and lower back conditions. Dr. Schuler is noted among the 100 best spine surgeons in America, and serves as President of the National Spine Health Foundation as well as Chairman of its Medical and Scientific Board. Learn more about Dr. Schuler.