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Cervical Disc Replacement vs ACDF: Which Should You Choose?

Cervical disc replacement and ACDF are both viable treatments for neck pain and radiculopathy

If you have neck pain or radiating pain caused by damage to the cervical spine, you have treatment options. You don’t have to live in pain, but you may have to choose which procedure is right for you. How will you know?

At Edison Spine Center, two of the most effective surgeries we offer for the cervical spine are artificial disc replacement and anterior cervical discectomy and fusion (ACDF). Learn what makes them similar and different, and when to choose disc replacement vs fusion.

ACDF: What It Is

ACDF has been the gold standard in cervical spine surgery for many years. It is safe, effective, simple to perform and easy to recover from.

Spinal Disc Herniation

An ACDF surgery has two parts. First, the damaged or herniated cervical disc is removed entirely (discectomy). Then a bone graft is placed over the affected vertebra to encourage it to grow into the backbone above or below it (fusion). This eliminates potentially painful movement of the vertebrae.

“Anterior” means the surgeon access the cervical spine through the front of the neck, which is easier, instead of the back.

Many people can return to work and light activity in a matter of weeks, although some may take longer (a month or more) to recover. The vertebrae will be fully fused in about three months.

Cervical Disc Replacement: What It Is

Cervical disc replacement is also known as total disc arthroplasty or artificial disc replacement. In this procedure, a damaged cervical disc is removed and replaced with a metal or polymer prosthetic.

First, surgeons make a slit in the side of the neck and carefully move away any tissue. The damaged disc is removed, along with any bone spurs. Then, the prosthetic is inserted and the incision closed.

It’s possible to return to work and light activity in two to four weeks after a cervical disc replacement. More vigorous activity may need to wait six to eight weeks.

Advantages of Each

Both of these procedures can effectively treat herniated discs, degenerative disc disease and other cervical spine conditions. Patients will work with their surgeons to decide which procedure is better for their particular condition and case.

ACDF Advantages

ACDF can be preferable for many reasons, including:

  • ACDF is established: Surgeons have been performing ACDF procedures for decades. Its effectiveness and safety profile are both known quantities.
  • ACDF can treat more people: People who have had previous neck surgery, damaged vertebral bones and facet joint degeneration may all be candidates for ACDF.
  • ACDF is probably covered by insurance: This goes back to the fact that ACDF is an established procedure with a long positive record.
  • ACDF is less complicated than a cervical disc replacement: The artificial disc must be sized and placed precisely in a disc replacement. There is no such requirement for ACDF.

Cervical Disc Replacement Advantages

Cervical disc replacements have been gaining popularity in recent years, and for good reason. They are safe procedures and effective at easing cervical pain or radiculopathy.

  • Disc replacement doesn’t require a bone graft: Just as ACDF doesn’t require an artificial disc, cervical disc replacement avoids a bone graft. ACDF risks nonunion, where the bone graft fails to fuse the spine. On the other hand, once a prosthesis is sized and inserted correctly, there’s a much lower risk of failure.
  • Disc replacement spares motion: ACDF removes the ability for the fused vertebrae to move. This is to cut down on pain, but it may also change the spine’s biomechanics. A properly sized and placed artificial disc preserves motion.
  • Disc replacement may have a quicker recovery: Cervical disc replacement does have to wait for a bone graft to fully harden. As a result, some disc replacement patients may be fully recovered up to a month earlier than if they had had an ACDF.

In comparing these two procedures, there really is no “better,” just better for you and your situation. Both are safe, effective procedures. It is up to you and your surgeon which one to choose.

Need neck surgery? Request an appointment at Edison Spine Center. Our spine experts can analyze your case and help you choose a procedure that will work best for you.