Jack Eichel's Battle for Disc Replacement Surgery

Due to the nature of the sport, many professional hockey players require cervical intervention at some point in their careers. The NHL’s current Collective Bargaining Agreement (CBA) has recently come into focus because of the rules on player’s treatment decisions and the roles the teams play in the decisions regarding their players’ treatment plans. The CBA states that the NHL teams have the final say in the medical treatment of their players, but the players can elicit a second medical opinion. Jack Eichel, formerly of the Buffalo Sabers, recently brought this section of the CBA into the spotlight. When it was time for Eichel’s neck surgery, the Sabers approved the typical NHL treatment of Cervical Fusion, but Eichel was in search of another treatment option: Disc Replacement. This led to a feud between Eichel and the Sabers which eventually led to his stripping of his captaincy and his trade from the Buffalo Sabers to the Vegas Golden Knights. The Golden Knights allowed for his Disc Replacement Surgery in 2021, and Eichel helped lead the team to win the 2023 Stanley Cup. Because of Eichel’s fight and determination to receive Disc Replacement Surgery, it has been at the forefront of hockey news. But why was Eichel so adamant about having this surgery, and what makes the NHL’s two cervical interventions so different?

Let’s start with the NHL gold standard, Cervical Fusion. Cervical Spinal Fusion, just as it sounds, involves fusing together two or more of the vertebrae in the neck. Typically, the surgeon will make an incision on the front of the neck and remove the injured cervical disc. The disc is replaced with a bone graft either from a donor or from your own hip bone. This bone graft will work as a network to allow the vertebrae to fuse together and heal as a single unit. The fusing of these two vertebrae eliminates motion in the location of the original trauma. Due to the lack of motion in the location where the disc was removed, it is common for the surrounding discs to have to work harder for movements which could result in the degeneration of the neighboring discs over time. Although there is less motion in the neck, once the bones are fused together, it results in an incredibly strong and solid section of vertebrae where damage is unlikely to happen at this fused location.

Disc Replacement Surgery involves replacing the damaged disc with a medical device that mimics the normally functioning human cervical disc. Like the Fusion Surgery, the surgeon will make a small incision on the front of the neck and remove the damaged cervical disc. This damaged disc is then replaced with the disc-mimicking medical device. Following this surgery and recovery period, most, if not all, motion in the neck is preserved. This means that the surrounding discs can work as expected and it is unlikely that repeat surgery in the same area will be needed.

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For each of these surgeries, the recoveries are similar: rest, healing, and working toward regaining strength and motion. For Cervical Fusion, the expected recovery is much longer, and NHL players are typically not expected to return to play for at least six months. With Disc Replacement Surgery, Eichel was able to return to full-contact gameplay in about three months. Even if you aren’t a professional athlete, this shortened recovery time can be a huge draw to Disc Replacement Surgery.

The question remains: if Disc Replacement Surgery could provide players an option to return to play sooner, retain motion in the neck, and lessen the chances of further operations, why did the NHL and Buffalo Sabers fight so hard against Eichel? Spinal Fusion Surgery was the gold standard in the past, and Disc Replacement Surgery was new and unprecedented within the NHL. The idea of Eichel being the first player to undergo this surgery was enough for the Buffalo Sabers to deny his surgical choice. Although Disc Replacement Surgery had never been successfully completed on an NHL player, Eichel and his team of medical professionals were certain that this surgery would be successful and provide him with a better quality of life in his future hockey career and life beyond the sport. After much retaliation, Eichel was traded to the Vegas Golden Knights, and the surgery was performed shortly after. After about three months of recovery, Eichel skated in his new Golden Knights uniform.