Cervical Fusion versus Disc Replacement Treatment Options

compare the two techniques

Surgeons use two techniques to relieve symptoms of degenerative cervical disc — cervical fusion surgery (also known as anterior cervical disc fusion or ACDF) and cervical disc replacement surgery. Both can relieve pain, weakness, and numbness. The difference lies in the lasting effect on your range of motion.

FUSION VS. ARTHROPLASTY

Dr. Jack Zigler presents the considerations when choosing cervical fusion over cervical disc replacement. Dr. Zigler is with the Texas Back Institute in Plano, Texas.


Cervical Fusion versus ARTIFICIAL Cervical Disc Replacement

With both techniques, the doctor will access the cervical spine through the front of the neck and remove the deteriorated disc. The next step depends on the technique:

  • Cervical fusion surgery. The doctor fills the empty disc space and braces the vertebrae with a device made of bone or a medical grade plastic. One such device is the Zevo™ anterior cervical plate made by Medtronic. The device serves as an “internal cast.” Over time, the area fuses together. The fusion often alleviates symptoms but also restricts motion and flexibility. 
  • Cervical disc replacement. The doctor inserts an artificial cervical disc in the empty disc space. The Prestige LP™ cervical disc is an artificial disc made by Medtronic.

The artificial cervical disc mimics the motion of a healthy disc. 

See the charts below to compare the results of cervical fusion and cervical disc replacement, using Prestige LP, two years after the surgery.

The first chart shows results using Prestige LP at two adjacent levels. The trial was prospective (looking forward in time) and involved 397 patients (209 patients who received the Prestige LP cervical disc at two adjacent levels and 188 patients who underwent a fusion procedure, ACDF, at two adjacent levels).

The second chart shows results using Prestige LP at a single level. This prospective (looking forward in time), non-randomized study was conducted in the United States and involved 545 patients with 280 investigational patients receiving the Prestige LP cervical disc and 265 control patients who had received anterior cervical discectomy and fusion (ACDF) in a study that had been done earlier. 

Results at 2 Years PRESTIGE LP 2-Level ACDF

Overall Success

81.4% or 162/199

69.4%  or 111/160

Average Degree of Motion

51% had more than 4 degrees of motion*

Severe Complications

1.9% or 4/209

5.9% or 11/185

Rate of additional surgery at treated level

2.4% or 5/209

8% or 15/188

Post-op neurological exam = the same or improved

91.5% or 192/199

86.2% or 137/159

Median Return to Work

6 days sooner

Results at 2 Years PRESTIGE LP 1-Level ACDF

Overall Success

70.4 % or 159/224

63.2%  or 108/171

Average Degree of Motion

7.51 degrees of motion (range was 0 to 26 degrees) compared to 5.67 degrees prior to surgery

Rate of additional surgery at treated level

5%

8%

Median Return to Work

20 days sooner


Choosing Cervical Fusion or Disc Replacement

Decide the best surgical option for you by:

  • Understanding the similarities and differences in the two techniques
  • Learning the benefits and risk of each technique
  • Checking on your insurance coverage for both
  • Considering your lifestyle and treatment goals
  • Discussing both techniques with your doctor

Once you have gathered information and discussed the options with your doctor, you will maximize your chances for a positive outcome and return to feeling better.

Need help finding a neck surgeon? Use our handy "Find a Specialist" tool to find a surgeon near you.


*

100 out of 196 (51.0%) had more than four degrees of motion at both treated levels while bending the head forward to backward (flexion-extension).



Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.