Cervical Spine/Neck Pain Surgery: Artificial Disc Replacement

For some patients who are candidates for anterior cervical discectomy and fusion (ACDF) surgery, artificial disc replacement may be an alternative. At South Denver Neurosurgery, our experienced neurosurgeons are leaders in this relatively new procedure.

What is Artificial Disc Replacement?

Good candidates for artificial disc replacement are patients who:

  • Experience arm pain.
  • Experience numbness and tingling in the arm and hands.
  • Have good motion in the area where the neck bends.
  • Have degenerative disc disease in only one disc.
  • Have no allergies to stainless steel.
  • Have no significant neck pain

Artificial disc replacement in the cervical spine is an innovative procedure that employs advanced technology. A 2016 study found that artificial disc replacement resulted in better function outcomes, less need for additional surgery, and fewer complications than ACDF. Other potential benefits of artificial disc replacement over traditional fusion surgery include:

  • Maintains full range of neck motion.
  • Reduces the likelihood of degeneration in adjacent segments of the cervical spine.
  • Eliminates the potential complications associated with bone graft used in ACDF surgery.
  • Shorter recovery time; most patients are able to resume normal activities within a few weeks.
  • Most patients can resume full activity, including vigorous activities, such as jogging, in as soon as three months.

Watch an animation that shows the range of neck motion after artifical disc replacement.

The procedure is not appropriate for all patients. Artificial disc replacement in the cervical spine is not recommended for patients who:

  • Have arthritis in the facet joint.
  • Have osteoarthritis in the cervical spine.
  • Have instability in the cervical spine.
  • Have active infection.
  • Have had previous fusion surgery in the area of the degenerated disc.
  • Need more than one level addressed

In artificial disc replacement, a small incision, usually about 1-inch, is made, most often in the neck fold, and the degenerated or diseased disc is removed. Once the disc is removed, a new disc, specifically sized to fit the patient, is inserted. Many artificial discs consist of two metal endplates separated by a polyethylene — or plastic — spacer.

With disc replacement surgery, additional stabilization measures are not necessary, and most patients are discharged from the hospital within 24 hours.

The risks of artificial disc surgery are comparable to those of most surgical procedures, and include surgical site infection. As with fusion surgery such as ACDF, there is a slight chance that the implanted device will move out of place, but this is extremely rare. Because artificial disc replacement is a relatively recent procedure, it isn’t yet clear how long the implanted discs will last.

Recovery After Artificial Disc Replacement

Recovery and rehabilitation from artificial disc replacement surgery are different for everyone, but in general, here’s what you might expect:

  • Some patients experience minor pain at the incision site, and some at the base of the neck and the shoulder blades. Typically, over-the-counter or prescription pain relievers can help.
  • Your bandages likely will come off the second day after surgery, but you may need to visit your neurosurgeon after you go home to have sutures removed.
  • Some patients will wear a soft or rigid neck support after surgery.
  • You may experience hoarseness or a sore throat. This is normal, and the symptoms will resolve within a few weeks.
  • You will be able to eat your normal diet.
  • Your neurosurgeon will advise you regarding when you can resume taking a regular shower or bath. You should not enter a pool or hot tub for several weeks.
  • You should be able to sleep in any position after you return home.
  • Many patients are able to resume driving after a week or two but you and your neurosurgeon will discuss when it’s appropriate for you to drive. You will not be able to drive as long as you are taking prescription pain medications.
  • You may start physical therapy after a few weeks.
  • You should be able to return to full activities by four to six weeks.