Cervical spinal fusion and total disc replacement

Cervical intervertebral disc degeneration is a leading source of neck and arm pain. The traditional treatment for cervical disc disease was spinal fusion, which was regarded as the gold standard method of treatment. However, a high rate of complications, including adjacent segment degeneration, was often associated with such fusion. In an effort to avoid adjacent segment disease, non-fusion techniques, including total disc replacement and nucleus replacement, were developed as alternatives. Unfortunately, clinical research has indicated that cervical disc replacement did not significantly reduce the postoperative rate of adjacent segment degeneration and adjacent segment disease. Biomechanical factors play an important role in the degeneration or rehabilitation progress of the musculoskeletal system. In the present study, the biomechanical effect of spinal fusion and total disc replacement on the surrounding tissues was analyzed based on the finite element method. The results showed that adjacent intervertebral disc pressure was not apparently different from the intact healthy condition after either spinal fusion or total disc replacement. It also showed that total disc replacement would increase the facet joint contact force and capsular ligament tension. The increase in facet joint loading is a potential source of facet joint degeneration.