Cervical Disc Replacement (Arthroplasty)

Relieve nerve pressure. Preserve motion. Get back to your life.

Cervical disc arthroplasty, also called cervical disc replacement, is a motion-preserving alternative to cervical fusion for carefully selected patients with a damaged cervical disc.

The procedure removes the damaged disc and replaces it with an artificial disc designed to relieve pressure on the nerves or spinal cord while maintaining motion in the neck.

The goal of spine surgery isn't to perform the most advanced procedure. It's to perform the right procedure for the right patient.

  • The cervical spine consists of seven vertebrae in your neck. Between these bones are discs that act as cushions and allow your neck to move.

    A disc can become damaged or degenerated, potentially causing:

    • Neck pain

    • Arm pain

    • Numbness or tingling

    • Weakness

    • Spinal cord compression

    • Difficulty with balance or coordination

    During cervical disc replacement surgery, the damaged disc is removed and replaced with an artificial disc.

    The goals are to:

    • Remove the damaged disc

    • Relieve pressure on the nerves or spinal cord

    • Restore the height of the disc space

    • Preserve motion at the treated level

  • After anesthesia is given, a ~2.5 inch incision is made on the front of the neck. The windpipe and esophagus is moved over the side, the injured disc is removed, and the nerves and spinal cord are carefully relieved of the damaging pressure.

    The implant is placed, with confirmation on intraoperative X-ray, in the middle between the vertebral bones. The wound is checked for bleeding and the incision is sutured closed.

    1. Relieve nerve compression

    2. Maintain motion in the cervical spine

  • A fusion (ACDF) is an effective and safe procedure that has been the gold standard. More recently, the disc replacement was introduced to maintain motion in the neck and decrease the stress that goes through the neighboring levels.

    For certain problems including severe arthritis, a disc replacement cannot be performed and fusion is preferred.

    For those that meet disc replacement criteria, recovery is quicker (return to sport/work), motion is preserved at the diseased level, and rates of additional surgery are lower.

  • Most patients go home the same day as the procedure.

    Soreness from the incision site can remain for a week or two, along with hoarseness and some difficulty swallowing.

    Unlike a fusion, there is no waiting for bone graft to consolidate, which can take months.

    Return to work times vary, some people are able to return to light work 1 week after surgery. For those with a very physically demanding job, return to work may not happen until 4-6 weeks after surgery.

  • Decrease neck pain by at least half and decrease arm symptoms by at least 70%.

  • There is no surgery without risks. They include but are not limited to: bad reaction to anesthesia, injury to vocal cords, injury to esophagus, difficulty swallowing, surgical site infection, prolonged pain, nerve injury, spinal cord injury, spinal fluid leak, and the need for additional surgery.

  • Cervical disc replacement may not be appropriate for patients with:

    • Significant facet arthritis

    • Severe cervical instability

    • Significant deformity

    • Advanced degeneration

    • Poor bone quality or osteoporosis

    • Certain inflammatory conditions

    • Significant spinal trauma

    • Anatomy unsuitable for the artificial disc

    • Other conditions that make motion preservation inappropriate

    In these situations, ACDF or another procedure may be a better option.

Neck MRI showing disc herniation

Neck MRI showing disc herniation

Device Size

Device Size

Implanted Device X-Ray

Implanted Device X-Ray

FAQs

1. Who is a good candidate for cervical disc replacement?

Cervical disc replacement may be an option for patients with a cervical disc herniation or degeneration causing arm pain, numbness, weakness, or spinal cord compression who have not improved adequately with nonsurgical treatment.

The best candidates generally have appropriate spinal alignment, good bone quality, and healthy facet joints without significant instability or advanced arthritis. A detailed examination and imaging are necessary to determine whether disc replacement is appropriate.

2. What is the difference between cervical disc replacement and ACDF (Fusion)?

Both procedures remove the damaged disc and decompress the nerves or spinal cord. The difference is what happens afterward.

With ACDF (anterior cervical discectomy and fusion), the disc space is stabilized by allowing the two vertebrae to fuse together. With cervical disc replacement, an artificial disc is placed between the vertebrae to preserve motion at that level.

Neither procedure is universally better. The best choice depends on your anatomy, diagnosis, and individual circumstances.

3. Is cervical disc replacement better than a fusion?

Not necessarily. Both cervical disc replacement and fusion are effective procedures when used in the appropriate patient.

Disc replacement is designed to preserve motion and may have advantages related to the biomechanics of the levels adjacent to the surgery. However, some patients have arthritis, instability, deformity, or other conditions that make fusion a better option.

The goal is not to choose the most advanced procedure—it is to choose the right procedure for your spine.

4. What symptoms can cervical disc replacement treat?

Cervical disc replacement is primarily used when a damaged disc is causing nerve or spinal cord compression.

Symptoms may include:

  • Neck pain

  • Shooting or burning pain into the arm

  • Numbness or tingling in the hand or arm

  • Arm or hand weakness

  • Loss of hand coordination

  • Balance or walking difficulties related to spinal cord compression

The procedure is particularly effective when symptoms can be clearly matched to the affected level of the cervical spine.

5. Will my arm pain, numbness, or weakness go away after surgery?

Arm pain often improves quickly after the pressure is removed from a compressed nerve. Numbness and weakness can take longer to recover because the nerve may need time to heal.

The amount of recovery depends on factors such as how severely the nerve was compressed, how long it was compressed, and whether there was permanent nerve damage before surgery.

Surgery removes the pressure from the nerve or spinal cord, but the nerve still needs time to recover.

6. Does cervical disc replacement prevent adjacent segment disease?

Cervical disc replacement is designed to preserve motion at the treated level. Research suggests that motion-preserving surgery may reduce some of the biomechanical changes associated with fusion and may reduce the risk of certain adjacent-level problems.

However, disc replacement does not guarantee that you will never develop degeneration at another level. Degenerative changes can occur naturally with aging, regardless of whether you have had surgery.

7. How long does it take to recover from cervical disc replacement?

Recovery varies depending on the patient and the severity of the underlying condition. Many patients are walking and performing light activities immediately after surgery.

Arm pain may improve relatively quickly, while numbness, weakness, and spinal cord-related symptoms can take weeks or months to improve.

Your return to work, exercise, driving, and other activities will depend on your individual recovery and the type of work or activity you perform.

8. Can I return to sports and an active lifestyle after cervical disc replacement?

For many appropriately selected patients, returning to an active lifestyle is an important goal of treatment.

After adequate healing and rehabilitation, patients may be able to return to activities such as hiking, cycling, golf, skiing, running, and strength training. The timing depends on your recovery, neurologic function, and the demands of your particular activity.

There are professional athletes in the NHL and PGA tour with cervical disc replacements.

9. What are the risks of cervical disc replacement?

As with any surgery, cervical disc replacement has potential risks. These include infection, bleeding, nerve or spinal cord injury, persistent or recurrent symptoms, difficulty swallowing, hoarseness or voice changes, implant wear or migration, and the possibility of needing additional surgery.

There are also risks specific to approaching the cervical spine from the front of the neck.

The benefits and risks of disc replacement should be considered in the context of your individual diagnosis, anatomy, and treatment alternatives.

10. When can I shower after a cervical disc replacement?

Dr. Sikora uses waterproof bandage after surgery, so you can shower the same day after surgery.

11. What positions should I sleep in after surgery?

Whatever position you find comfortable is the right one. Some prefer on the side, some on the belly, some on the back; there is no one univeral position to sleep in. There are also risks specific to approaching the cervical spine from the front of the neck.

How do I know if cervical disc replacement is right for me?

There is no single procedure that is best for every patient with a cervical disc problem. The decision depends on your symptoms, physical examination, imaging, spinal alignment, facet joints, bone quality, and overall goals.

The first step is determining exactly what is causing your symptoms. Once the diagnosis is clear, we can discuss whether nonsurgical treatment, cervical disc replacement, fusion, or another procedure is most appropriate for you.