Who should consider cervical disc replacement vs. cervical fusion for cervical radiculopathy and in what cases?
Patients with radiculopathy can initially be treated nonsurgically. Anti-inflammatory medication, therapy, and steroid injections can treat radiculopathy. If these treatments fail and symptoms persist, surgical intervention (fusion or disc replacement) is generally recommended. Proper patient selection for a total disc replacement is essential for a successful outcome. Not all patients are candidates for TDR. A fusion is still more commonly performed than TDR because of selection criteria. A total disc replacement is FDA approved for a single level use without prior fusion. In general, if there are extensive arthritic changes in the cervical spine, a total disc replacement may not be the ideal treatment choice as it only addresses arthritis in the front of the spine. If there is extensive arthritis behind the spine, it will not be affected by a TDR. The use of TDR for myelopathy (spinal cord compression) is under much discussion and has not been well defined in the scientific literatur
