Surgery Options for a Cervical Herniated Disk

Question: Cervical Herniated Disk Surgery Options?

I have a large cervical herniated disk (C5-C6) pressing into the spine. I have seen four neurosurgeons who have convinced me that I need surgery, and quickly, as I have signs of spinal cord damage. One spine doctor recommended the Bryan artificial disk, one recommended a cage, and another recommended autograph bone fusion.

I am concerned with the long-term risks and post-operative effects of each option for treating the cervical herniated disk and would appreciate your advice.

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Doctor’s Response: Anterior Cervical Discectomy and Spinal Fusion

For a cervical herniated disc surgery, the gold standard is an anterior cervical discectomy and fusion. Autograft bone is believed to heal the best, although harvesting the graft from the patient has a fairly high chance of graft site morbidity (20-25%), such as postoperative pain where the graft is taken from the patient’s hip. Most surgeons also add a plate to the front of the cervical spine at the fusion site, as it provides for added stability. Cage technology is just a different way of obtaining a fusion.

At this point, the Bryan disc is still being investigated, and you are right that there is no long term track record.

Practically speaking, a one level fusion does not greatly affect the mechanics of the neck. There are a lot of motion segments in the neck and fusing one does not put all that much pressure on the unfused disc segments. However, in certain cases, artificial disc technology may prove to be useful in the future to help maintain the normal mechanics of the spine.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.