Donald Corenman, MD, DC
Post count: 8436

Fusion surgery (ACDF) for the cervical spine is not as deleterious as you might think. A one level fusion is consistent with play in the NFL (think Peyton Manning) and should not significantly change the outcome of surrounding levels.

Nonetheless, artificial disc replacements (ADRs) are good implants in the right circumstances. In my opinion, those circumstances are herniated discs causing cord or root compression with a relatively normal (mildly degenerative) disc space. ADRs do not work if the disc space is significantly degenerative or there is bony stenosis (narrowing of the canal due to bone spur) which by your report is most likely your case.

The reason that ADR is not a good selection for significant bony spinal stenosis is that ADR allows motion. Bony canal stenosis can require significant vertebral endplate removal to make sure the canal is open. The technique for implanting an ADR requires preservation of the endplates of the vertebral bodies. If there is residual bony compression of the canal and now you increase motion of the segment, there is a chance for compression of the spinal cord. This is what you are trying to avoid with a surgery at this level.

I understand that you want to preserve motion, especially with the degenerative changes in your neck, but you still have to pick the correct surgery to match the desired outcome (reduction of the risk of spinal cord injury).

Dr. Corenman