Overview of Cervical Disc Replacement

A relatively new procedure called cervical artificial disc replacement (ADR) has been proven safe and has effectively helped some people who have cervical radiculopathy. The most common surgery for this condition is anterior cervical decompression with fusion (ACDF).

Recent studies have begun to look at the outcomes after cervical ADR and compare the outcomes with those of ACDF.

This article describes cervical ADR and the benefits and drawbacks of the procedure.

Woman sitting up in bed massaging her own neck
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Overview

Artificial disc replacement is a relatively new technique that uses an anterior approach—which means the surgeon cuts into the front of your neck rather than into the back—to replace your ailing disc with an artificial one. It’s used to treat cervical radiculopathy and/or discogenic pain. It’s also used in revision surgeries.

Artificial disc replacement goes by a few other names, as well. These include total disc replacement, disc arthroplasty, total disc arthroplasty, cervical disc arthroplasty, or cervical disc replacement. 

Cervical Radiculopathy

Cervical radiculopathy causes neck pain and/or pins and needles down one arm. In severe cases, it can cause weakness. Most of the time, it's treated conservatively with medication and exercise.

The established surgical treatment for cervical radiculopathy, ACDF, is a long-time surgery standard and the most commonly done neck surgery. This procedure involves the fusion of (one or more) intervertebral joints,

One benefit of cervical disc replacement is that it maintains the height between the two adjacent spinal bones, while at the same time preserving the joint’s ability to move.

After ACDF, you’ll be completely giving up the ability to move your neck at the surgery site. There's also a risk of developing adjacent segment degeneration.

Benefits and Drawbacks

Cervical ADR is a newer procedure than ADCF, and it has been done more often in Europe than in the US. The North American Spine Society says that in the short term, for treatment of single-level degenerative cervical radiculopathy, ACDF and total disc arthroplasty may be comparable treatments.

A 2015 analysis found the following benefits of cervical ADR:

  • Better success with improving nerve symptoms
  • More motion preservation at the operated level
  • Fewer reported problems or complications related to the procedure
  • Less need for revision surgery

But even with this promising set of outcomes, the authors say, other benefits have yet to be proven, including blood loss during surgery, length of time you’ll spend in the hospital, and improved functioning.

Another study found a lower rate of revision surgery for the total disc replacement, as compared with ACDF. The authors also say that disc replacements may result in better recovery of function in the mid and long term.

And a 2016 meta-analysis found that cervical disc replacement was more successful than ADCF for the treatment of symptomatic cervical disc disease and that it lowered the risk of complications and follow-up procedures.

Some of the things that you and your surgeon would need to consider include whether your surgical team has experience with this procedure and whether you are willing to undergo surgery that's relatively new. Additionally, long-term outcomes are not known.

A Word From Verywell

In the US, cervical disc replacement is not common, but outcomes suggest that it is worthy of further research. Most people do not need surgical treatment for cervical radiculopathy, and even if you need surgery, the right procedure for you depends on many factors. Some considerations with cervical ACR involve the size of the implant and determining whether certain patients would benefit from one surgical approach versus another.

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