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Evidence to Improve Care

Cervical Artificial Disc Replacement Versus Fusion for Cervical Degenerative Disc Disease


Final Recommendation

  • Health Quality Ontario, under the guidance of the Ontario Health Technology Advisory Committee, recommends publicly funding cervical artificial disc replacement for cervical degenerative disc disease

Read the Final Recommendation Report

Cervical degenerative disc disease affects the part of the spine that is in the neck. It occurs when the cushioning discs between the vertebrae (the bones of the spine) start to deteriorate. The disease causes pain, numbness and weakness in the neck, shoulders, arms and hands. These symptoms can be disabling and impact people’s quality of life and ability to function.

When treatments such as medication and physical therapy are not enough, surgery is an option. The most common surgery is anterior cervical discectomy and fusion (often simply called “fusion”). With fusion, the disc is removed, and vertebrae are fused together. However, this surgery sometimes has a negative effect on the discs next to the one being treated. Another surgical option is to replace the disc itself; this is called cervical artificial disc replacement.

Health Quality Ontario looked at the effectiveness, safety, durability and cost-effectiveness of cervical artificial disc replacement compared with fusion for treating cervical degenerative disc disease. We also looked at the budget impact of publicly funding cervical artificial disc replacement and the preferences, values, and experiences of people with cervical degenerative disc disease.

Read the full Health Technology Assessment report for more information.

Cervical Artificial Disc Replacement Versus Fusion for Cervical Degenerative Disc Disease: A Health Technology Assessment (PDF)
February 2019

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The Ministry of Health is currently reviewing this recommendation.

The Ministry of Health has provided the following response: The Ministry has a standardized process in place to review Health Quality Ontario recommendations. This takes into consideration Ministry priorities, implementation options, the need for consultation with impacted stakeholders, and funding considerations.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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