Many people don’t realize that pain and numbness in the hands and arms can be caused by conditions in the neck. If you’ve tried medications, physical therapy, maybe even alternative therapies, and your pain or numbness persists over weeks or months — and threatens to keep you from enjoying life — surgery may be an option.
Once you’ve decided on surgery to relieve pain, your next decision is: What kind of neck surgery? There are many options, and the best one for you depends on many factors, including the cause of your pain, and your goals for surgery.
Two of the most common options are fusion surgery and cervical artificial disc replacement surgery. While both are common and effective, there are significant differences between the two.
Anterior cervical discectomy and fusion (ACDF) is a type of neck surgery that involves removing a damaged disc to relieve pressure on the spinal cord or nerve root. A cervical plate then is placed on the vertebra to provide stability. During surgery, a bone graft or other implant is placed in the space left by the removal of the disc, to provide stability. For most people, fusion surgery permanently eliminates pain, as well as numbness and tingling.
Cervical spine fusion surgery is a good option for patients who have:
- Degenerative disc disease
- Herniated disc
- Cervical stenosis
- Unstable or weak spine
The procedure is most successful if no more than two vertebrae are involved. When more vertebrae are fused, the procedure is typically successful in addressing pain. Often, however, the procedure results in some immobility.
Even when only two vertebrae are involved, some impairment of movement is likely, which has traditionally been considered a drawback to the procedure.
Another drawback to traditional ACDF surgery has been the potential that, in a small percentage of patients, vertebra will not fuse. In those cases, additional surgery may be necessary. However, with many cervical spine procedures at Neurosurgery One, we offer injections of adult stem cells — taken from the patient — which have been shown to promote successful vertebra fusion.
Cervical artificial disc replacement
Cervical disc replacement surgery, sometimes called cervical artificial disc replacement, is a newer technique that involves removal of a damaged or degenerated cervical disc.
Instead of implanting a bone graft and promoting fusion of vertebrae after the disc is removed, a surgeon replaces the damaged disc with an artificial disc device that has been proven safe to implant in the body.
A disc replacement device typically is composed of two metallic surfaces. One of those is attached to the upper vertebra, and the other to the lower vertebra where the disc has been removed. These metal implants can slide on each other or can be separated by a piece of medical-grade plastic.
One advantage of this leading-edge procedure is that the design of the implant device allows patients to retain motion in the affected area.
Candidates for cervical disc replacement surgery, like those for fusion surgery, include:
- Patients who have had ongoing neck pain for a long time
- Patients whose neck pain hasn’t been relieved by physical therapy or medication
- Patients with pain, numbness, tingling, or weakness involving the arm or hand
The procedure is best for those with only one or two damaged vertebrae. Patients who have osteoporosis are not good candidates for disc replacement surgery.
For those patients who are good candidates, cervical disc replacement surgery may be a good alternative to fusion surgery. This technology allows me to accomplish surgical pain relief while preserving the patient’s mobility.
In addition, studies indicate that because artificial disc replacement eliminates the need for additional surgery. And, many patients like the fact that they probably won’t have to wear a neck brace or collar after artificial disc replacement surgery.