Hello Sb4ca, this was a choice that I had to make myself....fusion or disc replacement for cervical stenosis.

I chose fusion for several reasons. I was able to have a fusion with no hardware on a single level C5/C6 and stay in a hard collar until fusion began which was 3 months. That may sound impossible, but it went by quickly and I was making the choice because I wanted to avoid metals and foreign substances in my body. I had allergic reactions to my pierced earrings and had to give them up completely. My surgeon told me it heals best with just a bone spacer. Anything that is screwed into bone can become loose or pull out and that is an even greater risk if there is poor bone quality. With aging, osteopenia and osteoporosis can become an issue, and the fusion would be stronger than any hardware attached by screws that the body does not attach to on its own. Sometimes, the spine will grow bone around a disc replacement implant attempting to stabilize it which then requires re-operation and a fusion. The loss of spine motion with a fusion depends on what level it is. At C5/C6, it does not affect my ability to turn my head at all and most of that is done by C1 & C2 with lesser help from C3 & C4. I can no longer touch my chin to my chest in forward flexion, but it is pretty close. Bone also has some spring to it and hardware attached will make it stiffer which would transfer a bit more stress to adjacent discs. I asked my surgeon about adjacent disc disease in relation to fusions and number of levels fused. The risk goes up when more levels are fused which makes sense because it puts more pressure on the discs at the top and bottom end of the fusion because it is doing the job of more levels that no longer move. A fusion shrinks as the bone heals, and with a metal plate attached to the front of the spine, if the plate is too long, it can start to rub on the discs at the ends affecting them. Adjacent segment disease also happens with disc replacement implants, and also to patients who have had no spine surgery. I am 5 years post op from my fusion and there is no adjacent segment disease as confirmed by a recent MRI. I have been doing everything I can to maintain good posture and build core strength because that is what my surgeon advised to prevent future spine problems. I work with a physical therapist who also does myofascial release to get my body back in proper alignment and relieve the stresses caused by tight fascial tissue. That pressure can also affect the spine. Your surgeon can give you statistics on adjacent segment disease. It is true that the risk is a bit higher with fusions, but there are other factors that affect it also. I had one damaged level from an auto accident years ago, and the other discs were fairly normal. With aging, discs dry a bit and shrink and that can open up a crack that may be there from an earlier injury like a traffic accident. For me that took about 20 years for the disc to rupture.

There is a lot of information about myofascial release in this discussion with lots of links on the first pages.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Here is a very important topic to add to your discussion. The symptoms you describe can also be attributed to thoracic outlet syndrome. That is not to say they are not spine related, but you can have both problems at the same time and your doctor may be missing the TOS if you have it. It is a common problem, but is often misunderstood by doctors because it is complex and is glossed over in med schools (according to my neurologist). I was told it was rare by a doctor who missed my diagnosis, and he had no explanation for why my circulation changed in my arms with a change of position in Doppler imaging studies. That is what TOS does. It causes pinching of nerves and blood vessels traveling to the arms. This bundle of nerves (and vessels) leaves the spinal cord and passes through scalene muscles and under the collar bone and under the Pec Minor muscles. These are all tight spaces that can get smaller with TOS. Whiplashes can cause spine injures and TOS, so the injury that caused a spine problem may have caused TOS as well, and add to that stressful jobs, poor slouching posture, and some people who have less space under the collar bone because of their physical build. As you may have guessed, I had both TOS and a ruptured C5/C6 disc with compression of my spinal cord at the same time. My TOS was missed entirely by the hand surgeon who a few years earlier operated on my carpal tunnel (another condition that causes similar overlapping symptoms) and he didn't know why my hands were turning bluish and purple and getting cold to the touch. It was TOS cutting off the blood supply and causing weakness and tingling in my arms. I also had muscle atrophy on the back of my arms and shoulders caused by spinal cord compression that affected the Deltoids and Triceps. I had been working with a physical therapist for TOS at the time the disc ruptured and I stopped progressing. The ruptured disc caused bone spurs to grow next to it and it started pressing into my spinal cord.

This is a good technical article about TOS.
https://mskneurology.com/how-truly-treat-thoracic-outlet-syndrome/

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