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What’s for the best - spinal fusion or a disc replacement?

By Rosie Hewitt
Rehabilitation And Delegated Claims Manager

If you’ve suffered a disc problem in your neck or back, which has not improved with conservative treatments such as physiotherapy or steroid injection,- you may be offered a surgical intervention such as a –“spinal fusion with discectomy” or a new and relatively unknown surgical procedure – a “discectomy with an artificial disc replacement”.


A Discectomy literally means "cutting out the disc." It can be performed anywhere along the spine from the neck (cervical) to the lower back (lumbar); – usually the C6 or L5 discs are the most problematic. If you have, for example, prolapsed your C6 you’d likely be experiencing numbness in your fingers (thumb and forefinger), reduced strength and difficulty lifting objects. You may even lose the power in your tricep muscle_

So what’s  the difference between a fusion and a disc replacement?

A Spinal fusion, also known as spondylodesis, is final. – It uses a combination of bone graft and hardware (screws/plates) to connect two vertebrae together and fuse over time into one piece of bone. It is used to eliminate the pain caused by abnormal motion of the vertebrae by immobilizing the faulty vertebrae themselves and which are usually the result of degenerative conditions or spinal deformities.

Spinal fusion is most common in the lumbar region of the spine, but it is also used to treat cervical and thoracic problems. It can result in a loss of range of motion - as a result it is commonly the treatment of choice for those who are very active (eg athletes) or in physically demanding work -  (eg heavy labour workers) – and where the back or neck has been injured by fracture, tumour and disease such as scoliosis. .

On the other hand, a discectomy with an artificial disc replacement helps to relieve pain and restores motion between affected vertebrae by replacing a damaged intervertebral disc with a prosthesis. And it can prevent the risk of spinal joint problems above and below a fusion site.  It’s more appropriate if the problem is disc related as opposed to disease related.

Sounds like a good idea? Well, there are always risks. Artificial disc replacement is new type of surgery and its longevity and outcomes are unknown, making it impossible to rule out further operations down the line. There are some medical conditions – such as osteoporosis or obesity for which it is unsuitable.

Either way, medical advice will guide any decision.