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Learn How Artificial Disc Is Improving Neck Surgery

Authored by Dr. Thomas Schuler, MD, FACS, FAAOS. June 25, 2016

Disc replacement surgery continues to be one of the great, exciting developments in spinal health care. Five years of research data have shown that disc replacements outperform spinal fusions, especially when more levels of the spine are involved. When one suffers from a severe impingement of a spinal nerve or suffers from severe, intractable neck pain related to arthritis, stabilizing that level of the neck is often the best treatment. Traditionally, this was done by fusing the neck, removing the disc, removing the spurs, and then putting a bone graft in and stabilizing it.  More recently disc replacement has been a more effective option to help improve a patient’s symptoms without the limitations of a spinal fusion. Spinal fusions are designed to stop motion, whereas a disc replacement preserves the natural motion of the spine.

HOW ARTIFICIAL DISC REPLACEMENT WORKS

Each level of the spine is compromised of three joints:  the disc and two facet joints in the back of the neck. Disc replacement replaces the disc and does nothing to the two joints in the back of the neck. For the artificial disc to function optimally, the facet joints should operate normally prior to surgery. What we have learned over years, however, is that even with some mild facet arthritis, patients do quite well with disc replacement surgery. That’s not to say that fusions don’t work well, but they do elimination motion at that level and put more stress on the adjacent levels. There are several instances in which a patient would opt for maintaining range of motion in their neck – i.e. career, activity level, quality of life. That is the beauty of the artificial disc.  It preserves motion at the surgical level and, therefore, does not increase stress at the adjacent level of the spine.

THE FUTURE OF DISC REPLACEMENT

I have been performing disc replacements for over ten years but within the past five years have started implementing multilevel disc replacements, and hybrid surgeries. Hybrid surgery is one in which we fuse one level or more and then place an artificial disc at another level or more. This mixture allows us to get the best result for the patient. In levels that are severely scarred or severely arthritic that a disc replacement will not improve their function, a fusion is often the best treatment. At levels where motion is preserved, the arthroplasty will often produce a more desired result. I know this personally since I have had one level of my neck fused and the adjacent two replaced with artificial discs. I am functioning better than I was before surgery, which occurred four years ago.  I saw continued improvement in my neck function and symptoms for over one and one-half years after surgery and have done extremely well for the past two and one-half years. I am back playing all of the sports that I desire, including golf, swimming, tennis, as well as weight lifting.  Most importantly, I am still able to be an active spinal surgeon using my skills to help improve other’s lives. Disc replacements are a promising advancement and are continuing to improve my life, as well as my patients.

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Dr. Thomas Schuler, MD, FACS, FAAOS

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