How are the Results for Anterior Cervical Discectomy and Fusion?
General consensus by most surgeons and patients report a 95%-98% success rate in terms of relief of arm pain. That statistic is very important for everyone to understand. Cervical Discectomy Surgery is successful for ARM PAIN. Unfortunately, that does not mean neck pain, or headaches.
Just like any procedure, surgical or not, the success is determined by proper selection of the patient. For Cervical Discectomy patients, the ideal candidate is a healthy, normal weight adult, without any significant arthritis of the spine, that has an isolated single disk herniation, located to one side with corresponding arm pain, weakness, numbness or tingling that does not respond to the usual conservative treatments or time. With no other sources of pain, medical risks, and anatomy concerns, this patient would be predicted to have an excellent result with improved arm pain . Unfortunately, most patients do present with other issues that may factor into a less than ideal outcome.
Anterior Cervical Discectomy and Fusion can improve neck pain, and headaches, but the rates of success specifically for those two problems are not as predictable. The reason being, the causes of both the neck pain, and headaches are very difficult to exactly define. In terms of neck pain, it can be secondary to arthritis of the facet joints of the neck, with corresponding pain caused by rubbing of the arthritic joints. While fusing that level may alleviate some of the neck pain, usually, cervical facet joint arthritis is diffuse, so you run the risk of still having neck pain despite fusion to one or two levels, as the third or fourth level may still be the cause of discomfort. If you have neck fusion for facet arthritis, please make sure you have investigated all the potential other cause of neck pain, and ask if your surgeon has isolated the neck pain to the specific levels of fusion.
Cervical Discectomy and Fusion for headaches can be equally as challenging. While it is true that neck pain can cause headaches, and that nerves of the back of the neck can cause headaches, it is difficult to associate all your headaches specifically to one or two areas of the neck. As a great secondary effect, after a patient has Cervical Discectomy and Fusion for arm pain, often they notice improvements in neck pain and headaches. But, the predicted outcome of headache and neck pain relief is not as accurate as the prediction in improvement of arm pain, tingling and weakness.
The best outcomes occur in patients that understand the goals of the surgery. Cervical Discectomy surgery has excellent predicted outcomes in terms of arm pain. But you, the patient, need to understand that it may, or may not, relieve other concerns.
- Davis RJ, Nunley PD, Kim KD, Hisey MS, Jackson RJ, Bae HW, Hoffman GA, Gaede SE, Danielson GO 3rd, Gordon C, Stone MB. Two-level total disc replacement with Mobi-C cervical artificial disc versus anterior discectomy and fusion: a prospective, randomized, controlled multicenter clinical trial with 4-year follow-up results. J Neurosurg Spine. 2015 Jan;22(1):15-25. PubMed PMID: 25380538