Orthopaedics What Is Bi-Level Disc Replacement? By UPMC Orthopaedic Care, July 13, 2017 Bi-level disc replacement is a surgery used to treat bi-level disc herniations (ruptures) in the neck. Doctors perform a bi-level disc replacement when two separate discs are pinching two nerves. The pinching of these nerves causes symptoms that include: Arm pain Arm weakness Arm numbness During a bi-level disc replacement, doctors remove the discs that are pinching the nerves and replace them with a mobile joint. Fusion Versus Bi-Level Disc Replacement You may be a candidate for bi-level disc surgery after other treatment methods have failed. Ten years ago, the traditional surgery method for disc herniation was a fusion. During a fusion procedure: An orthopaedic surgeon removes the discs pinching the nerves and inserts a spacer that fuses the remaining vertebrae. This method, however, does not allow for complete range of motion between levels because the bones have grown, or fused, together. Because motion cannot occur between the levels that were fused together, motion increases between the bones above and below the fusion. This can cause the bones to wear out sooner and puts the patient at risk of needing additional surgeries. Benefits of Bi-Level Disc Replacement Surgery With bi-level disc replacement, a mobile joint is used in place of a spacer, which allows the patient to retain motion. According to UPMC Orthopaedic Care spine surgeon Scott G. Rainey, DO, at Tri Rivers Musculoskeletal Centers, research shows that a bi-level disc replacement improves long-term results and overall joint function, while reducing the potential need for additional surgeries. Following a fusion, the range of motion and activity level of a patient is limited while the bones fuse together. Because there is no waiting period following a bi-level disc replacement, patients are often able to return to work and daily activities more quickly. Candidates for Bi-Level Disc Replacement Dr. Rainey says candidates for fusions aren’t always candidates for bi-level disc replacement. Your doctor will typically order an MRI to determine that there is disc herniation and/or spinal cord impingement. You may be a good candidate for bi-level disc replacement if you: Have failed non-operative treatment methods Are young and active Have had no neck pain before the onset of arm pain Do not have advanced arthritis in your neck Recovery and Rehabilitation for Bi-Level Disc Replacement Patients typically find relief following a bi-level disc replacement because the discs pinching the nerves are removed. And, unlike with a fusion, bi-level disc replacement patients can take anti-inflammatories for pain after surgery. Since there is no waiting period for two bones to fuse together, the metal joint that replaces the disc is well-incorporated within the first few weeks following surgery. So, patients do not have the same long-term restrictions to protect a bi-level disc replacement as they would with a fusion. During the first two weeks of recovery, driving is restricted, and patients should not lift more than 10 pounds. According to Dr. Rainey, most patients are back to regular activity within three months of the surgery.