I hate when someone tries to sell me something I don’t want. It could be anything, but I’m sure most people would agree that when it comes to your health and wellbeing, or that of a loved one, choosing a doctor you trust to provide accurate medical advice is crucial to your healthcare experience.
Wondering whether or not your doctor is presenting you with all possible treatment options is the last thing you should have to worry about. Making a sound and confident treatment decision is vital for undergoing the best surgery experience possible, which is why patient transparency and trustworthiness are values our spine care team at NJ Spine & Orthopedic firmly believes in.When it comes to patients suffering from neck pain due to common spinal conditions like bone spurs and a herniated or degenerated disc, a treatment option many doctors try to sell their patients is a neck (or cervical) fusion. If you or someone you know has been recommended a neck fusion, I strongly urge you to get a second opinion – don’t let any doctor try to sell you a neck fusion.
Why? First off, there are several misconceptions associated with fusion procedures that need to be cleared up. A cervical fusion locks and limits motion in your neck by preventing the affected vertebral disc from moving by fusing it together with the vertebral disc above it. This is typically done to treat neck pain caused by bone spurs and herniated discs. The truth is, most patients who have neck pain, arm pain, herniated discs, spinal arthritis or bone spurs end up with a fusion.
Cervical Artificial Disc Replacement: The Preferred Solution to Neck Pain
In fact, about 95% of spine surgeons prefer performing a fusion to an alternative treatment, such as a cervical artificial disc replacement. The irony in this situation is these doctors would most likely never succumb to a fusion themselves and would instead ask for an artificial disc replacement. Why? Artificial disc replacement has several advantages, but to appreciate them it’s better to first understand the negative impacts of a fusion and what exactly it does to your body.
Neck Fusions Debunked
As I mentioned above, a cervical fusion limits the motion in the spine segment (or vertebra) fused. Contrarily, your neck naturally wants to move, so over time the segments surrounding the fused area overcompensate and increase motion in the adjacent bony-disc segments. This can be good at first; once the segments start moving more you can actually regain some of the neck motion. In many cases though, this motion ends up being a bad thing, as this motion causes excessive wear to the adjacent moving segments as they begin overworking themselves to compensate for the lack of motion in the fused segment or segments. This eventually causes the surrounding vertebrae to break down early, causing a condition known as adjacent segment disease. Most doctors would tell you that you’ve just qualified for yet another fusion.
Undergoing neck surgery once is bad enough, but having to get a second fusion means the majority of your neck will essentially be immobile! This could even result in additional surgeries down the road and lead to a life of uncomfortable fusion side effects.
What is a Cervical Nonunion?
When you have a fusion there are other problems that can occur. A nonunion, which means a failure to fuse, is one of those problems. When a nonunion occurs, another surgery is usually required because if the segment does not fuse, the pain and problems will only multiply.
There are many causes for a fusion to unsuccessfully fuse and smoking is a big one, followed by not wearing a brace – generally patients must wear a neck brace for about two months after a fusion.
Smoking and Nonunion Fusions
Smokers heed caution – you really do not want to undergo a cervical fusion! I don’t recommend smoking to anyone, but if you do smoke, a cervical fusion is NOT a good idea.
Cervical fusions in smokers have a high incidence of nonunion due to the absence of microvascular circulation. This type of circulation is what helps fuse a bone together by bringing blood to the area undergoing the healing process. During the act of smoking, microvascular circulation is destroyed, so without blood properly being brought to the spine, it will not heal.
A second surgery after you’ve already had one is not fun, but there can be a light at the end of the tunnel in a failed surgery or nonunion scenario – The solution is a cervical artificial disc replacement to revert the original fused area back to a moving, working part of your spine.
An Effective Fix to Nonunions and Failed Fusions
Cervical artificial disc replacement is the latest advancement in non-fusion alternatives to neck pain. Today, very few orthopedic clinics both on a national and international scale possess the proper experience to perform this type of procedure.
At NJ Spine & Orthopedic, we specialize in revision neck surgery to fix failed surgeries with cervical artificial disc replacement taking up 25 percent of all surgeries performed, happening almost on a weekly basis. Revision surgery essentially “fixes” what another surgeon has done, and most can be done in an outpatient setting using minimally invasive techniques. Additionally, unlike fusions, the recovery process of an artificial disc replacement does not require wearing a brace.
Cervical Artificial Disc Replacement: A Smoker’s Alternative
A cervical disc replacement is also a great option for smokers, as there is generally less difficulty involved in this type of minimally invasive procedure.
Smokers who need neck surgery and only want surgery once should have an artificial disc replacement. Since there is no fusion involved, the problems with a potential nonunion are virtually nonexistent.
Do you think you may be qualified for a cervical artificial disc replacement? Take our Candidacy Check Tool to find out. Check out our doctors’ page to learn more about Dr. Katzman and the rest of our spine surgeons at NJ Spine & Orthopedic.