Cervical Disc Replacement
Cervical disc replacement treats a herniated disc or bone spur in the neck the same way a fusion does, by removing the disc and relieving pressure on the nerve or spinal cord, but instead of fusing the two vertebrae together, it places an artificial disc that keeps the level moving. For the right patient, it is a motion-preserving alternative to ACDF with excellent long-term results.
How the operation works
The approach is through a small incision at the front of the neck, following natural tissue planes to reach the spine without cutting muscle. The disc is removed along with any bone spurs pressing on the nerve or spinal cord. An artificial disc, a metal-and-polymer implant sized to the space, is then placed between the vertebrae. It restores the disc height, which opens the nerve openings, and allows the level to continue to bend and rotate.
Disc replacement versus fusion
Both operations relieve nerve compression equally well. The difference is what happens afterward. A fusion eliminates motion at the level, which shifts slightly more stress to the discs above and below over the years. A disc replacement preserves motion, and long-term studies from the FDA trials that approved these implants, now extending past ten years, show outcomes at least as good as fusion with fewer additional operations at neighboring levels for appropriately selected patients.
Disc replacement is not right for everyone. When the joints behind the disc are significantly arthritic, when the bone is osteoporotic, when there is instability, or when the disc space has collapsed, a fusion is the more reliable choice. Dr. Michael reviews your imaging with you and explains which situation applies.
Recovery
Most patients walk within hours and go home the same day or the next morning. A sore throat and some difficulty swallowing are common for a few days. A rigid collar is usually not required. Desk work typically resumes within one to two weeks, driving once off narcotic pain medication and able to turn the neck comfortably, and most activities by six weeks. Because there is no fusion to wait for, activity is advanced based on comfort and healing of the soft tissues.
Common questions
How long does an artificial cervical disc last?
The implants in use today have been followed for more than a decade in clinical trials with low rates of revision. As with any implant, they can wear or loosen over a long period, but this has been uncommon.
Can I have a disc replacement at two levels?
Yes. Two-level cervical disc replacement is FDA-approved for specific implants and has strong long-term data. Beyond two levels, fusion or a combined approach is usually recommended.
Will I feel the implant?
No. Patients do not feel the implant. Neck motion is preserved and usually feels natural once the soft tissues heal.
Does insurance cover cervical disc replacement?
Most major insurers cover it for one- and two-level disease when criteria are met. The office verifies coverage before surgery is scheduled.