Cervical Disc Replacement
Motion-preserving surgery to relieve cervical nerve compression without fusion
Cervical disc replacement — also called cervical disc arthroplasty — is a surgical procedure that removes a diseased or herniated cervical disc and replaces it with an artificial disc implant, restoring disc height and decompressing the nerve root or spinal cord while preserving motion at the treated level. It uses the same anterior cervical approach as ACDF (Anterior Cervical Discectomy and Fusion) but avoids bone grafting and a metal plate — instead, an artificial disc is seated between the vertebral bodies. The procedure was developed to address a known long-term concern with fusion: adjacent segment disease, in which fused levels transmit abnormal stress to neighboring discs, accelerating their degeneration. By preserving motion, cervical disc replacement may reduce — though not eliminate — this risk.
Who Is a Candidate?
- Cervical disc herniation with radiculopathy (arm pain, numbness, or weakness) at one or two levels
- Cervical degenerative disc disease causing neck pain with radiculopathy at C3–C7
- Failed conservative care for ≥6 weeks (physical therapy, NSAIDs, cervical epidural steroid injection)
- Age typically <60, without significant osteoporosis (bone density must support implant fixation)
- Absence of significant cervical facet joint arthritis (facet arthritis limits benefit of motion preservation)
- Absence of cervical instability, spondylolisthesis, or significant ossification of the posterior longitudinal ligament
What to Expect
1Before Surgery
Candidacy requires MRI confirming disc herniation consistent with symptoms, and X-ray or CT to assess facet joint integrity and bone density. Pre-operative evaluation includes cervical alignment assessment — neutral or lordotic alignment is required for optimal implant function. Inform your surgeon of all medications, particularly blood thinners. Arrange a driver and post-operative support; you will return home the same day or after one night.
2The Procedure
Under general anesthesia, you lie on your back with the neck slightly extended. The surgeon makes a small horizontal incision on the front (anterior) of the neck, moves the trachea and esophagus aside to access the anterior spine, and removes the diseased disc completely. The endplates are prepared to accept the implant, and the foramen is decompressed under microscopy. An appropriately sized artificial disc — typically a metal-on-polymer or metal-on-metal device — is pressed into position between the vertebrae. No graft, no plate, and no screws are required. Fluoroscopic X-ray confirms alignment. Total operative time is typically 1–2 hours for a single level.
3Recovery
Most patients are discharged the same day or after one night. Unlike ACDF, no bone fusion is required — many surgeons use no collar at all, or only a soft collar for 2–4 weeks for comfort. Return to desk work typically occurs at 2–4 weeks. Driving is restricted for 2–4 weeks. Physical therapy typically begins at 4–6 weeks. Return to full activity including non-contact sports occurs at 3–6 months. Fusion confirmation X-rays are not needed — motion is verified at follow-up.
Typical Outcomes
Cervical disc replacement produces equivalent or superior outcomes to ACDF for arm pain relief, with 80–90% of patients reporting significant improvement at 2 years. Long-term data (7–10 years) demonstrates durable results and motion preservation. The rate of adjacent segment disease requiring reoperation is lower with disc replacement than with fusion in most studies. Patient satisfaction is high, particularly for younger, active patients who want to avoid the constraints of a fused segment.
Risks & Considerations
- Device failure or malposition requiring revision surgery
- Heterotopic ossification — bone formation around the implant reducing motion (occurs in 15–20% of cases, rarely symptomatic)
- Dysphagia (swallowing difficulty) — same risk as ACDF, resolves in most patients within weeks
- Hoarseness from recurrent laryngeal nerve irritation (rare, usually temporary)
- Infection at the surgical site (<1%)
- Adjacent segment disease — reduced compared to fusion but not eliminated
- Implant loosening or subsidence in patients with osteoporosis (a contraindication)
Frequently Asked Questions
What is the difference between cervical disc replacement and ACDF?
Both procedures approach the spine from the front of the neck and remove the same diseased disc. The difference is what happens next: ACDF replaces the disc with a bone graft and a metal plate, fusing the two vertebrae permanently — the treated level no longer moves. Cervical disc replacement inserts an artificial disc that allows continued motion at the treated level. Outcomes for arm pain relief are equivalent; the main potential advantage of disc replacement is reduced stress on adjacent levels over time.
Am I a candidate for cervical disc replacement instead of fusion?
Candidacy depends on several factors: the number of levels involved (disc replacement is best suited for one or two levels), the presence of significant facet joint arthritis (which limits benefit from motion preservation), bone density (osteoporosis is a contraindication), and cervical alignment. If you have a straightforward one or two-level herniation with intact facets and good bone density, disc replacement is typically a viable option. Your spine surgeon will review your MRI and X-rays to determine which procedure is more appropriate for your anatomy.
Will I need to wear a cervical collar after disc replacement?
Unlike ACDF, which requires bone fusion and typically involves a collar for 6–12 weeks, cervical disc replacement does not require fusion — the implant is mechanically stable immediately. Many surgeons use no collar at all, or a soft collar for 2–4 weeks for patient comfort. You should follow your specific surgeon's instructions, as protocols vary by device and surgical approach.
What is heterotopic ossification and does it affect outcomes?
Heterotopic ossification (HO) is the formation of bone in soft tissues around the implant — a known complication of cervical disc replacement that occurs in 15–20% of cases. When HO is severe, it can bridge the disc space and effectively create a fusion, eliminating the motion-preservation benefit. However, most HO is mild or moderate and does not cause symptoms. Patient outcomes are generally good even when HO occurs, because the primary benefit — nerve decompression — is already achieved.
Find a verified Cervical Disc Replacement surgeon
Browse spine surgeons and neurosurgeons who perform cervical disc replacement. Filter by location, insurance, and availability.
Search spine specialists →Related Conditions
Medical disclaimer: This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with any questions you may have regarding a medical condition or surgical procedure. Last reviewed April 2026. CPT: 22856.