Understanding spinal fusion
Many people are surprised to learn that in spine surgery for a herniated disc, the disc is not actually repaired during surgery. Instead, in most cases, the herniated disc is actually removed from between the vertebrae, and a piece of bone is installed in its place, along with a plate and screws, permanently locking the vertebrae together. The reason that the disc is typically removed, is that once the wall of the disc has ruptured, more of the soft nucleus will continue to escape in the future, impinging upon a nerve root and requiring a another spine surgery.
During your Internet search on spine surgery, you may learn that spinal fusion procedure is a common treatment for herniations in the low back, simply because artificial discs for the low back are still evolving and improving.
In the neck, however, there have been many advances over the past five year, along with corresponding research that is now favoring the benefits of artificial disc surgery for the neck.
Concerns about the early cervical artificial discs caused many surgeons to be cautious. Similarly, health insurance companies are typically skeptical of any new technology. That is changing quickly as more research documents that artificial disc can provide great advantages over spinal fusion.
This is especially the case in the neck where there are only 6 spinal discs (with the vertebrae labeled C-1 to C-7), compared to 17 below that in the thoracic and lumbar spine. The thoracic vertebra are labeled with a T and the lumbar vertebrae are labeled with an L.
A herniated disc in the neck, if fused, can put more stress on the remaining 5 discs and potentially causing herniations at the other levels. If 2 of the 6 disc levels are fused, the person would have little ability to rotate their neck.
Consequently, there has been great effort by artificial disc companies to get their disc approved by the FDA for 2 levels. This enables the spine surgeon to maintain nearly the same natural rotation of the normal healthy disc in the neck.
If your spine surgeon determines your herniation does qualify for an artificial disc, you may be able to retain the natural rotation in your neck which would lessen the stress placed other discs in your neck, and lowering the risk of a second herniation and another spine surgery later on.
As to evaluating the pros and cons, another factor is your age at the time of your surgery. For the person in their 50s or 60s, chances are good that the disc may last a lifetime. For the younger person with a herniated disc, such is in their 20s, 30s or 40s, revision surgery may be an issue at some point if the artificial disc wears out.