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Replacements vs Fusions

Replacements vs Fusions

Artificial Disc Replacements are the future of motion preservation surgery.

What is a Fusion?

What is a Fusion?

Fusions in the spine are generally performed in situations that require reconstructing the spine or dealing with instability that results from trauma, tumors, or removal of bone, disc, ligament, or joints in the spine. In many instances, fusions are the gold standard surgery, especially when fractures or deformities, such as scoliosis or kyphosis, are being addressed.

Fusions, when combined with procedures that remove disc or bone that is pinching or placing pressure on the nerves or spinal cord, can eliminate pain, reestablish proper alignment, and provide structural stability to the spine. The disadvantages of spinal fusion, however, include loss of movement in the spine, added stress and strain on the discs and joints above and below the fusion, development of chronic pain, and commonly the need for additional surgery in the future.

Spinal fusions will require either a hard cervical collar or a back brace to ensure success of the surgery for at least 3 months.

Why We Prefer TDA

Why We Prefer TDA

A rigid fusion with screws and rods will limit a patient’s range of motion of their spine. Whereas a disc replacement will preserve motion. If we can allow the patient to keep their full mobility, this is preferred!

Also, frequently a patient’s neck or low back disc is collapsed and their motion is impaired at this level. A disc replacement can then improve their range of motion at this level. 30% of the time, a patient who has a previous fusion will require additional surgery at the levels above or below the fusion construct.

Whereas, a disc replacement will not lead to adjacent level degeneration and therefore reduces the risk for additional surgery in the future. Many of our cervical and lumbar disc replacements can be done in an outpatient surgery center, allowing the patient to go home the same day. Therefore, a disc replacement allows for fewer hospital stays and reduces healthcare costs as well. 

A TDA only requires a soft cervical collar for 2 weeks or no bracing at all for the lumbar spine. A disc arthroplasty also has less risk for hardware malfunction, again decreasing the risk of further surgery.