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.
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)
Last reviewed: 2026-05-10· Author: Chad Tuchek, MD · Cotton O'Neil Neurosurgery and Spine Center, Stormont Vail Health
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