Cervical Arthroplasty (Disc Replacement)

Cervical arthroplasty (cervical disc replacement) is a procedure in which a diseased disc between two vertebrae in the neck is removed and replaced with an artificial disc implant. The implant is intended to allow motion between the two vertebrae, unlike in a spinal fusion. The discs between our vertebrae function like joints, so you can think of a cervical arthroplasty as being akin to a hip or knee replacement, except for a joint in the neck.

Common reasons for a cervical arthroplasty include pain radiating from the neck down into one or both of the arms (cervical radiculopathy) or compression of the spinal cord in the neck (cervical myelopathy), often due to a herniated disc.

Why perform a disc replacement instead of a fusion? Arthroplasty has the advantage of preserving motion, meaning that natural movements are the neck are less affected than in a fusion. Because a fusion limits motion between two segments of the spine, it may place additional stress on the joints above and below it, which can accelerate arthritis and lead to pain or other problems over time, a phenomenon we call adjacent segment degeneration. Studies have suggested that patients undergoing cervical arthroplasty rather than fusion may have lower rates of adjacent segment degeneration.

The technique of cervical arthroplasty is very similar to that of anterior cervical discectomy and fusion (ACDF). The procedure begins with a short incision on the front of the neck. The surgeon dissects down to the front of the spine and then accesses the disc between two neighboring cervical vertebrae. The disc is removed, and then an artificial disc is inserted between the two vertebrae.

Below is a view of the cervical spine from the front showing the vertebrae and the discs between them. One or more of these discs is removed in a cervical arthroplasty.

Cervical arthroplasty can be an excellent alternative to a spinal fusion in the carefully selected patient - particularly young patients with relatively healthy spines who are hoping to preserve neck motion.