Cervical Spine
Cervical Disc Arthroplasty
Motion-preserving alternative to ACDF for select single-level disc patients. Replace the disc instead of fusing the segment.
What it is
Cervical disc arthroplasty replaces the diseased disc with a small mobile artificial joint, rather than fusing the vertebrae together as ACDF does. The implant allows continued motion at the operated level, which can be advantageous for younger patients and for the long-term health of the discs above and below.
The surgical approach is essentially identical to ACDF — a small transverse incision at the front of the neck — and the discectomy and decompression portions of the operation are the same. The difference is what we put back in.
Why this procedure when surgery is needed
For the right patient — typically younger, with single-level disease, well-preserved disc height, and minimal facet arthritis — disc arthroplasty offers comparable nerve decompression to ACDF while preserving motion. The trade-off is the discipline of patient selection: not everyone is a candidate.
Long-term studies suggest a possible lower rate of adjacent-segment disease (additional surgery at the level above or below) compared to fusion. The data are not unanimous, but they are favorable for appropriately selected cases.
What to expect
Surgery typically takes 1–2 hours per level.
Most patients go home the same day.
Mild sore throat and swallowing discomfort for a few days is normal.
Return to desk work in 1–2 weeks; light activity sooner than ACDF in most cases.
No collar needed; gentle range of motion encouraged early.
Cervical motion at the operated level is preserved.
Risks and how we reduce them
The approach and early risks of disc arthroplasty mirror ACDF, with a few risks specific to placing a motion-preserving implant instead of a fusion.
Expected, temporary effects
Sore throat and difficulty swallowing. As with ACDF, gently moving the swallowing tube aside leaves many patients with a sore throat and some difficulty swallowing for days to a few weeks.
Hoarseness or voice change. Temporary hoarseness from irritation of the nerve to the voice box can occur and usually recovers.
Serious risks
Heterotopic ossification. Bone can form around the implant over time and gradually reduce or eliminate the motion the device is meant to preserve, in some cases behaving more like a fusion.
Implant wear or migration. The artificial disc can wear or shift over the long term and rarely requires a revision, sometimes to a fusion. Careful patient selection reduces this risk.
Persistent hoarseness. Lasting injury to the recurrent laryngeal nerve, causing persistent voice change, is uncommon.
Nerve or spinal cord injury. Injury to a nerve root or the spinal cord is rare and can cause new weakness or numbness.
Infection. Wound or deeper infection is uncommon and is minimized with sterile technique.
Your recovery, phase by phase
A general timeline for this procedure. Your surgeon’s own protocol takes precedence — use this to know what to expect and what questions to ask at each visit.
Before surgery
- Stopping nicotine before surgery improves wound healing and lowers infection risk — the earlier you stop, the better.
- Review every medication and supplement with the pre-anesthesia team; blood thinners, NSAIDs, GLP-1 medications, and some supplements are held on a schedule set for you.
- Shower with Hibiclens the night before and the morning of surgery, and stop eating after midnight; the anesthesia team sets your clear-liquid cutoff.
- Arrange a ride home for the same day — this is usually an outpatient operation.
The day of surgery
- Arrive about two hours early to check in, change, have an IV placed, and meet your surgical team.
- The approach is the same as ACDF — a small incision at the front of the neck under general anesthesia — but the disc is replaced with a mobile implant instead of being fused; each level takes about one to two hours.
- You are positioned on your back (supine) while asleep.
- Your family waits nearby; Dr. Tuchek speaks with them as soon as the operation is finished.
In the recovery unit
- You wake up in the PACU. A mild sore throat and some swallowing discomfort are common for a few days.
- Most patients go home the same day, once swallowing safely, walking, and comfortable on oral medication.
- No collar is typically needed, and gentle neck motion is encouraged early.
The first two weeks
- Arm pain is often relieved early; sore throat and swallowing discomfort settle over several days.
- Because the implant preserves motion, gentle range-of-motion is usually encouraged rather than restricted — follow your surgeon’s specific guidance.
- Keep the incision clean and dry. Many patients return to desk work within one to two weeks and drive again once off narcotic pain medication.
Weeks 2 to 6
- Activity returns faster than with a fusion for most patients; avoid heavy lifting and high-impact activity until your surgeon clears you.
- A follow-up visit checks the incision and confirms the implant position on imaging.
Long-term recovery
- Motion at the operated level is preserved, which may reduce stress on the discs above and below over time.
- Once cleared by your surgeon, patients typically return to full activity, including exercise, on their own timeline.
Milestone checkpoints
| Window | Milestone | What to expect |
|---|---|---|
| Post-op days 1-3 | Sore throat and swallowing | A mild sore throat and some difficulty swallowing for a few days is common after the front-of-neck approach, just as with ACDF. Soft foods, small bites, and staying upright while eating help; it settles on its own. |
| Post-op days 1-3 | Gentle neck motion is encouraged | Because the implant is designed to preserve motion, gentle neck movement is usually encouraged early rather than restricted. Follow your surgeon's specific guidance for your case. |
| Post-op days 1-3 | Shower | Keep the incision dry for the first 48 hours, then a normal shower is generally fine unless you are told otherwise — no scrubbing, pat dry. Follow your discharge instructions. |
| Surgeon-directed | Cervical collar | A collar is typically not needed after disc arthroplasty because the goal is to keep the segment moving. If your surgeon does prescribe one, wear it exactly as directed. |
| Checkpoint | Driving | Resume once you are off all narcotic pain medication and can comfortably turn your head and react in an emergency. Your surgeon confirms this at your first post-op visit. |
| Checkpoint | Return to work | Desk work is often possible within one to two weeks; jobs with lifting or overhead work take longer. Your surgeon clears the timeline that fits your operation and your job. |
| Week 6 | Activity returns, often faster than a fusion | Because nothing needs to fuse, many patients progress activity sooner than after an ACDF. Avoid heavy lifting and high-impact activity until your surgeon clears you, and follow their protocol rather than a fixed date. |
| Any time | When to call | Call the office for fever or an incision that is draining, reddening, or spreading. Rapidly worsening neck swelling, trouble breathing, worsening difficulty swallowing, or new arm or leg weakness is an emergency — call 911. The clinic phone line is not an emergency line. |
Prepare and recover
Handouts that fit this surgery. These are being finalized in physician review — visit the patient education library to see what is available, and always follow your own surgeon's specific protocol.
Prepare for this surgery
Recover from this surgery
Approach
- Anterior cervical approach (same as ACDF)
- Operating microscope for decompression
- Disc completely removed; endplates carefully prepared
- Motion-preserving implant sized and seated under fluoroscopy
- Standard ACDF post-op pain control protocol
Typical indications
- Single- or two-level cervical disc herniation with radiculopathy or myelopathy
- Younger patients (typically under 60) where motion preservation matters
- Well-preserved disc height at the affected level
- No significant facet arthritis at the operated level
- No cervical instability or deformity
Alternatives we considered
- ACDF for multi-level disease or significant facet arthritis
- Posterior cervical foraminotomy for select lateral-only nerve compression
- Continued conservative care if symptoms are stable
Related conditions
This procedure is most often performed for:
Videos for this procedure
- ACDF (Anterior Cervical Discectomy & Fusion)(in production · 7 min)
Medical review in progress. Author: practice editorial team.
The information on this page is general patient education and is not a substitute for individualized medical advice. For urgent symptoms, call 911 or go to the nearest emergency department. For non-urgent questions, call (785) 368-0767 during clinic hours.
Not sure whether a symptom needs a call? When to call after surgery