Spine News: Cervical Disc Replacement vs ACDF Explained, Latest Surgery Video, SMISS 2026, A New Chapter
Cervical Disc Replacement vs ACDF Explained
What, how, why, and more…
If you’re dealing with neck pain, or symptoms due to a damaged disc in the cervical spine, there are two surgical options most commonly recommended: cervical disc replacement and ACDF (fusion). In my latest video, I break down how each one actually works, where they’re surprisingly similar, and where they truly differ, including something most patients don’t expect about pain and recovery.
I also walk you through what to consider before deciding on neck surgery, what the patient journey actually looks like from that first visit, and how to prepare for your surgeon visit so you get the most out of it. Plus, I cover how imaging like MRI and X-ray actually helps guide the decision, and why imaging alone is never enough to make that call on its own. Get ready to take a deep dive with me in this video!!!
Latest Surgery Video
81-Year-Old Gardener | Pinched Nerves Treated With LESS
My latest video shows the surgery of an 81-year-old patient with degenerative scoliosis and nerve compression at three spinal levels. A case like this would traditionally call for a large fusion from the mid back to the pelvis. Instead, I relieved all three pinched nerves using LESS (Lumbar Endo Spine Surgery) through a single small incision, preserving the stability of the patient’s spine.
I explain the unique challenge the scoliosis posed, show the pathology at each of the three levels, and demonstrate how I used an ultrasonic bone resector and laser to decompress each nerve root, without the extensive surgery usually required for a case like this.
In this surgery, a bulging disc was adding to the pinching of the nerve, but the real culprit was a bone hook I traced along the SAP (superior articular process), going all the way down and pushing into the exiting nerve root. Once that was cleared, I debulked the disc so it will not rise up and push into the nerve later.
SMISS 2026
Highlight, Debate, and Something Special…
One highlight at the SMISS (Society for Minimally Invasive Spine Surgery) conference was a case Chad Prusmack, MD, presented on a cervical disc replacement for professional hockey player Jack Eichel. Under the Collective Bargaining Agreement, team doctors, not patients, had the final say on medical decisions, and Eichel wanted a motion-preserving disc replacement instead of a fusion. He fought for it at the risk of his own career, and his advocacy has helped other professional hockey players facing similar decisions. It’s a powerful reminder of what patient advocacy can do.
Here’s another controversy, when is the official 20 year anniversary of SMISS going to be?!!! Our first meeting in 2006 was unofficial, when Dr. Bill Taylor and I converted the UCSD MIS course into the first SMISS meeting. We met again in San Diego in 2007 and did all the paperwork to become an official non-profit organization, but we weren’t totally legit until 2008. So I think it’s either 2027 or 2028. I’d be curious what you think!!
One of my favorite moments at SMISS this year was finding an old pin from over 20 years ago, back when we first started. I had a bunch of them in the back of an old drawer, and I handed them out to the original members. It’s a vintage pin now, and it represents something big that we started together to promote minimally invasive spine surgery techniques, methods, and philosophies.
A NEW CHAPTER
UCSD Health Merging with Palomar Health
I’m proud to be a UCSD person. I went to UCSD as an undergrad back when it was still four colleges, and there was just one hospital, in Hillcrest. Now there’s a massive main campus in La Jolla, Hillcrest is still going strong, and a few years ago UCSD Health brought my hospital, Alvarado, into the fold as East Campus.
Now UCSD Health is joining forces with Palomar Health, bringing us into North County with a big, beautiful hospital. It’s going to be great for patients, providers, staff, and the community, and I couldn’t be prouder to watch UCSD’s reach keep growing!!!
Live More With LESS
Providing you with customized, precision medicine, while treating you like family.
