spinal health and treatment options
RSS Feed Dr. Praveen MummaneniSan Francisco, CA Cervical disc replacement is much easier to perform and to revise. |
 Dr. Michael NeuwirthNew York, NY I think there are a great many differences. 1) The typical treatment for lumbar disc herniation is from a posterior, not anterior, approach. 2) A lumbar disc replacement is done for discogenic lumbar back pain. This is, at the very least, a controversial indication for any surgery whatsoever. 3) Revision of lumbar discs is a challenging and often difficult procedure. With respect to the neck: 1) The indication for a cervical disc replacement is exactly the same as the indication for an anterior cervical fusion. There is no new indication that is necessary to justify the procedure. 2) Revision strategy for cervical disc replacement, should this become necessary, should be quite straightforward without the difficulties that are encountered in lumbar disc replacement. The magnitude of the surgery for cervical disc as compared to lumbar disc replacement is much less. The patient's recovery is much quicker. |
 Dr. Brett TaylorSt. Louis, MO The primary difference between cervical disc replacement and lumbar disc replacement in our practice is the indication. Cervical disc replacement is performed for patients with radiculopathy or arm pain due to nerve irritation in the neck. The success rate in alleviating arm pain after cervical disc arthroplasty is quite good. In contrast, the standard indication for lumbar disc replacement is for primarily back pain as opposed to leg symptoms. In addition, the surgical exposure for cervical disc replacement is quite familiar to surgeons as opposed to some lumbar disc arthroplasty, which requires an anterior lumbar exposure that is not as familiar for many spine surgeons. |
 Dr. J. Kenneth BurkusColumbus, GA You might as well ask me the difference in hip replacements and knee replacements. They are different parts of the body and they are completely different. While they are both part of the spine, the biomechanics, the loads, the shape and size of the prosthesis and what can be accommodated are completely different. |
 Dr. Rick SassoIndianapolis, IN There are huge differences. It starts from the beginning in regards to the indications. In the low back, it's low back pain without nerve problems. In the neck, it's nerve problems — not necessarily pain; in fact, the contra-indication is just back pain, so the diagnosis is much, much different. In the cervical spine we're dealing with significant neurologic problems. In the low back, we're dealing with no neurologic problems. The outcomes are also profoundly different. The cervical disc replacement outcomes are much better compared to the lumbar disc replacements. And the operation is much different. The anterior cervical approach is extremely familiar for essentially all spine surgeons. It's an outpatient operation, they go home the same day, whereas in the lumbar spine it's inpatient for two to three days. |
 Dr. Todd BonvalletChattanooga, TN The designs of the discs are somewhat similar, including the materials used. It is just that the cervical discs are much smaller than those used in the lumbar region. I feel that the advantage of artificial cervical disc is that if there is any complication that can occur we can easily go back in the neck and revise this with very little trouble and scar tissue. This is not so with a lumbar disc replacement. |
 Dr. Todd LanmanLos Angeles, CA Lumbar disc replacement surgeries are much more extensive since surgeons approach the spine through the abdominal cavity and have to go around the intestinal area and move large veins out of the way, usually using a surgeon such as a vascular surgeon to carefully remove large veins. In the cervical spine there's very little that needs to be moved out of the way. The small incision is made in the neck and dissection is carried out along the trachea and the esophagus, and the artery and vein in the neck simply push out of the way with a finger and the spine is readily exposed. This approach only takes a few minutes to obtain and the entire operation itself is about 45 minutes to an hour. My patients lose only about two tablespoons of blood. |
 Dr. Richard FesslerChicago, IL Huge. Perhaps the major difference is that the operation used to place a lumbar disc is a rather major undertaking, and any required revision of a lumbar disc is a risky procedure. On the other hand, the operation used for the cervical disc is the same as for a cervical fusion, and revisions are also much easier. |
 Dr. Paul BroadstoneChattanooga, TN In a lot of ways they are similar in respect to maintaining motion along the anterior spine and decreasing stress on adjacent levels. However, the biomechanics and stresses placed on the disc vary for the different areas of the spine and the disc replacement is designed to meet the requirements of that particular part of the spine. |
 Dr. Vincent TraynelisIowa City, IA There is a great difference between these two types of disc replacements and the surgical procedures used to implant them. Cervical disc disease is often treated from the front of the spine, whereas that is not the case for lumbar disc problems. The cervical disc replacement operation is a very low risk procedure, which can be easily revised if necessary. That is not true of lumbar arthroplasty. |
 Dr. Joseph StachniakPlano, TX The cervical spine is not load bearing, like the lumbar spine. And the need for surgery can be greater for patients with neurodeficit or arm pain, as opposed to low back pain. |
The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.
It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.
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