While neither of these procedures is perfect, each approach has relative potential benefits and risks.

In This Article:

Potential advantages of cervical artificial disc replacement

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Potential benefits of Disc Replacement vs 2-level ACDF

Spinal fusions have been performed in the United States since as early as the 1950s, while disc replacement technologies have only been around since they were first approved by the FDA in the mid-2000s. Two-level cervical artificial discs have been approved for use for an even shorter period of time, and presently published data are only available for 2-year follow-up, although longer-term results are being tabulated. As such, longer-term risks and potential complications are less well known relative to ACDF.1Kepler CK, Brodt ED, Dettori JR, Albert TJ. Cervical artificial disc replacement versus fusion in the cervical spine: a systematic review comparing multilevel versus single-level surgery. Evid Based Spine Care J. 2012;3(S1):19-30. For some patients and surgeons, the most substantial potential future risk is if the disc implant would need to be removed at some point in the future. Since many people who are candidates for this procedure are relatively young, this is a significant consideration.

See Multilevel Fusion Risks

A second potential risk of cervical disc replacement is that the implant used may at some point suffer a mechanical failure or breakage; this is a risk for any newer type of implant and is not unique to the disc prosthesis per se.

See Indications for Two-Level Spinal Fusion

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More data on disc replacement is being generated every year, and longer-term outcomes are being carefully tracked under FDA monitoring, but both patients and physicians must understand that this is a newer surgical option without longer term experience. Reoperation rates after cervical disc replacement are generally less than after fusion surgery. Revision of a failed artificial disc implant to a fusion, although unlikely, is usually possible.

  • 1 Kepler CK, Brodt ED, Dettori JR, Albert TJ. Cervical artificial disc replacement versus fusion in the cervical spine: a systematic review comparing multilevel versus single-level surgery. Evid Based Spine Care J. 2012;3(S1):19-30.

Dr. Stefano Sinicropi is an orthopedic surgeon and the CEO of Midwest Spine & Brain Institute. He has been specializing in spine surgery for more than 15 years. Dr. Sinicropi is experienced in performing minimally invasive spine surgery and disc replacement surgery.

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