Monday, 27 May 2019 14:46

Why You Should Choose an Artificial Disc Over Cervical Fusion

There are several strong reasons why you should choose an artificial disc over a traditional Anterior Cervical Discectomy and Fusion  or ACDF.  Let us first look at what is the optimal goal for a traditional anterior discectomy and fusion. 


The surgeon has determined that your cervical disc has been compromised.  The disc can be damaged either by the natural aging process, or by a significant trauma.  The consequence of this damage will cause the disc to lose its height and due to this loss of height, the normal openings that the nerves use to exit the spinal cord begin to close pinching these nerves causing pain. This is called foraminal stenosis . 

Another issue that is seen is due to a violent rupture of the outer surface of the disc or annulus.  If a rupture occurs the soft jelly like substance located within the disc is extruded out or herniates.  This extruded substance can at times press against a nerve causing pain.

A traditional Anterior Cervical Discectomy and Fusion (ACDF) requires the surgeon to use plates, screws, and a spacer (inter body) to put the cervical spine back into its normal alignment.  The targeted disc is removed and is replaced by this spacer. 

The spacer can be made up of two main materials:

  • Polyetheretherkeytone (PEEK)
  • Titanium

The reason the spacer is used is to maintain the natural disc height which keeps the foramen open restoring the normal pathway for the spinal nerves to travel to the rest of the body.

After placement of the spacer the plate is then attached to the spine with screws.  The plate and screws are made of titanium and their sole purpose is to hold the spine at this new position allowing the body to grow bone creating a fusion mass at the level that would permanently fuse the spine.

The issue with this procedure is that it removes flexibility in the neck.  It also transfers the forces that the fused level would normally handle to the upper or lower level of the spine.  This transfer of forces typically causes an issue that is seen in fused patients.  These patients will require more fusion surgery to repair the new level.  This issue is called Adjacent Level Disc Disease  and is an unavoidable consequence of a traditional anterior cervical discectomy and fusion procedure.

When you compare the traditional ACDF procedure to an artificial disc procedure, you quickly see the benefits.  Unlike the loss of flexibility that you find after an anterior discectomy and fusion procedure when patients decide on an artificial disc, they keep their neck flexibility due to the design of the artificial disc. 

The artificial disc consists of 3 parts.  The top plate, the bottom plate, and the spacer in between.  The spacer is made up of a polyetheretherkeytone (PEEK) material.  It is designed to allow for almost a full range of motion between the upper and lower plate.  What this means for the patient is that they do not experience a loss of movement, and there is no adjacent level disc disease because the spine retains its natural movement.

The insertion of the artificial disc is a straightforward procedure.  The disc material is still removed, but instead of inserting a spacer and securing the area with plate and screws, the artificial disc goes in in one complete piece and is press fit into the space so there is no reason to use a plate or screws. In fact, current studies show that the artificial disc is significantly better than a traditional fusion.

At Advanced Orthopedics, our goal is to help you feel better and heal faster. Our advanced clinical skill and compassionate approach to treating your neck, back, shoulder, wrist, knee, and hip injuries and disorders are tailored to you and your particular condition. We embrace a compassionate, patient-first approach to orthopedic care and pain. Combined with extensive experience, innovative technology, and advanced treatments area able to provide you with the most comprehensive treatment plan. We are happy to review your MRI and discuss your options and answer all your questions to ensure you get the best treatment for you. For more information contact us at (407) 960-1717.