Ali Moshirfar, MD, is board-certified in orthopaedic surgery. He is a member of the Inova Neuroscience and Spine Institute and Chairman of the Department of Orthopaedic Surgery and Director of spine surgery at Inova Loudoun Hospital.
If you’ve had a slipped disk in your neck, you know how painful it can be. Also called a ruptured or herniated disk, it strikes when one of the rubbery cushions between the vertebrae ruptures. A ruptured disk can cause neck pain as well as numbness, tingling and pain in the arm or shoulder.
In the past, an operation known as spinal fusion was the go-to surgical fix for slipped disks. But a newer technique allows us to repair the damage without fusing the bones of the spine. For many people, this “motion preservation” surgery is a great option for replacing damaged disks and relieving the pain.
ACDF: Spinal Fusion
Slipped disks can occur anywhere along the spine, in people both young and old. Sometimes, people experience ruptured disks as a result of a sudden strain or injury. But often, they develop as a result of wear and tear. The rubbery disks between our vertebrae naturally begin to break down with age. When that happens, a slipped disk can occur after a relatively minor strain.
When someone has a slipped disk in the neck, we first try to treat them with nonsurgical options. These can include rest, medications such as steroid injections or anti-inflammatory drugs and sometimes physical therapy. If that doesn’t work, the traditional next step is surgery known as anterior cervical discectomy and fusion, or ACDF.
In ACDF surgery, we remove the damaged disk and fill the gap with a bone graft. Then we screw it all together with metal plates and screws to hold the bones in place while the graft heals.
Fusion is a tried-and-true treatment, but it’s not perfect. The biggest problem is that it puts extra stress on the disks above and below the fused area. That can potentially lead to more degeneration and more slipped disks or other spine problems in the future.
Artificial Disk Replacement: Motion-Preservation Surgery
In recent years, an alternative to spinal fusion has steadily gained popularity. Artificial disk replacement is just what it sounds like: During a surgical procedure, we remove the damaged disk and replace it with an artificial one.
Since the bones aren’t fused, this surgery preserves the normal motion of the spine. And it doesn’t result in added stress to the surrounding areas of the spine and adjacent disks, so there’s less risk of more neck problems down the road.
There are some other benefits, too. Compared to spinal fusion, patients who have artificial disk replacement don’t have to wait for the bone graft to heal before they resume unrestricted physical activities. That means they can usually get back to their regular routine more quickly.
Is Artificial Disk Replacement for You?
Not everyone is a good candidate for artificial disk replacement. It’s not advised for people who have osteoporosis or significant arthritis in the spine. But for many patients, it’s a great option for easing neck pain without increasing the risk of future problems.
When the procedure was new, many insurance companies didn’t cover it. Happily, that’s changed as this treatment has become more common. If your slipped disk is causing neck pain that just isn’t going away, it’s worth asking your doctor if you’d be a good candidate for artificial disk replacement
Sick of neck or back pain? Whether it’s caused by a ruptured disk or something else, we can help. The Inova Spine Program has more spine specialists than anyone in the region. Learn more about our treatment options for spinal conditions.