Spine Cervical

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My doctor has recommended a fusion for me (my neck). After two years of rehab, my pain is better but the X-rays, CT scans, and MRIs show it's not stable. Now we are talking about all the different options. The surgeon prefers to use something called ACDF with bone graft and a metal plate. I'd like to get by without the metal. Is it possible?

Sometimes when there's bone or disc degeneration in the cervical spine (neck), fusion is needed to stabilize the area. Over the years, one procedure in particular has gained popularity because of its effectiveness: the anterior cervical discectomy and fusion (ACDF).




I have a chance to be part of a study using a dissolving plate to fuse my neck. I'm wondering what you think about these.

Bioabsorbable plates are fairly new to the spinal fusion scene. For a long time now, surgeons have used an approach called the anterior cervical discectomy and fusion (ACDF). Anterior refers to the location of the incision and the way surgeon enters the spine (front of the neck). Anterior fusion is performed through the front of the spine to avoid the spinal cord and spinal nerves. Cervical refers to the neck and discectomy is the removal of the disc from between two vertebrae.




A Possible Solution to the Problem of Metal Plates in Neck Fusion

Bioabsorbable plates are fairly new to the spinal fusion scene. For a long time now, surgeons have used an approach called the anterior cervical discectomy and fusion (ACDF). Anterior refers to the location of the incision and the way surgeon enters the spine (front of the neck). Anterior fusion is performed through the front of the spine to avoid the spinal cord and spinal nerves. Cervical refers to the neck and discectomy is the removal of the disc from between two vertebrae.




I had a CT-scan that confirmed my worst fears: a herniated disc in my neck. The surgeons are talking about fusion versus maybe trying a disc replacement. I'm going in for more tests to see which treatment might work best for me. How do these two operations stack up against one another? Would you recommend one over the other?

Painful symptoms from a herniated disc can limit function and really reduce quality of life. If the condition gets worse, patients can end up with irreversible neurologic damage. That's why surgery is recommended if conservative care doesn't result in any change in the clinical picture.




I was one of the first people in our area to have a disc replacement for a herniated disc that was pressing on my spinal cord. That was five years ago. So far, so good. They did warn me that anything could happen -- I could end up with the implant pressing on the cord or another disc going bad above or below the implant. I like to keep up on this technology, should I ever need another one. What's the latest?

The condition you were treated for is called myelopathy. Myelopathy refers to a narrowing of the spinal canal, the opening formed by the vertebral bodies when stacked on top of one another. The spinal cord travels through the open spinal canal. Anything that narrows this opening (e.g., disc protrusion, bone spurs, hardening of the spinal ligaments) can put pressure on the spinal cord and cause serious neurologic problems.




Pitfalls of Cervical Disc Replacement

The authors of this article on the treatment of cervical myelopathy originally presented the results of a study comparing disc removal and replacement versus spinal fusion for this condition back in November 2008. Now, they offer a detailed look at the surgical technique and pitfalls of cervical disc arthroplasty (disc replacement in the neck), along with an update on this procedure.




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