Cervical Disc Replacement vs. ACDF - Dr. Trevor Schmitz
Dr. Trevor Schmitz discusses the difference between cervical artificial disc replacement (ADR) versus anterior cervical discectomy and fusion (ACDF) surgery.
What is degenerative disc disease?
"Degenerative disc disease is kind of just the spine wearing out. We all wear out as we age and the discs are no different in your neck - they wear out the same as any other part of your body, and that's what degenerative disc disease is disc, wearing out in your neck."
What treatment options to patients have for degenerative disc disease in their neck?
"Usually, before we talk about something like a neck surgery, I usually recommend to my patients that they try something like physical therapy – they can try various injection options. Sometimes if there is severe spinal cord pinching – surgery is the recommended treatment, but that's not very typical. Usually, we recommend other conservative treatment options first."
What is a cervical artificial disc replacement (ADR) srugery?
"Disc replacement surgery is actually going through the front of the neck, taking the disc out, and then replacing it with an artificial disc. And typically, that is done in order to take pressure off the spinal cord and nerves."
What is anterior cervical discectomy and fusion (ACDF) surgery?
"ACDF is an anterior cervical decompression and instrumented fusion, and what that essentially is, is going in through the front of the neck, taking that disc out, and then putting a little shim in with some cadaver bone and then usually a plate and screws over the front to hold everything in place."
How do you decide which surgical procedure a patient qualifies for?
"If we are trying to determine between something like a fusion and a disc replacement – a lot of it has to do with age how worn out the discs are, if there's any instability in the neck – usually a patient can't have a disc replacement. Sometimes if the discs are so collapsed, they can't have a disc replacement at that time."
What is the different between the recovery process between ADR and ACDF?
"Usually, the disc replacement surgery is a little bit faster recovery usually by about a month, month and a half because you don't have to limit the activity restrictions as long with the disc replacement surgery as we do with the fusion."
What should a patient consider when choosing a surgeon?
"Obviously with the surgeon, you want to make sure that they had good outcomes in the past and it's something that they've performed a lot of in the past. You also want to make sure that you feel like you can get along with your surgeon that you trust that surgeon."
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