Artificial cervical disc replacement: what to know
Cervical artificial disc replacement, also known as cervical arthroplasty, is a modern surgical technique used to treat specific neck conditions while preserving the natural movement of the spine. This procedure is often considered an alternative to spinal fusion, offering certain advantages for carefully selected patients. In this article, consultant neurosurgeon Mr John Yeh explains what the surgery involves, why it might be needed, and what to expect before and after.
What is cervical artificial disc replacement?
Cervical artificial disc replacement involves removing a damaged intervertebral disc in the neck (cervical spine) and replacing it with an artificial device designed to mimic the movement and function of a natural disc. These artificial discs are typically made from a combination of metal and plastic components. Common materials include medical-grade titanium or cobalt-chrome alloys for the metal endplates, and a polyethylene or similar polymer core to allow movement.
Unlike spinal fusion, which eliminates motion at the affected segment, disc replacement aims to maintain motion and reduce stress on adjacent levels of the spine.
Why might artificial cervical disc replacement be needed?
This procedure is most often performed in patients with cervical disc degeneration or herniated discs that cause nerve compression. Symptoms might include neck pain, radiating arm pain, numbness, tingling, or weakness in the arms or hands. These issues can arise due to wear and tear, injury, or disc disease.
Cervical disc replacement is typically recommended when conservative treatments such as physiotherapy, medications, or injections have not provided sufficient relief. It is particularly suitable for younger, active patients who have one or two affected disc levels and wish to preserve spinal movement.
How artificial cervical disc surgery is performed
Cervical disc replacement is usually done under general anaesthesia. The traditional method is an anterior open approach, which means the surgeon accesses the spine through a small incision at the front of the neck. After carefully moving aside muscles, nerves, and other soft tissues, the damaged disc is removed. The artificial disc is then inserted into the disc space and secured.
In some cases, a minimally invasive technique may be used, involving smaller incisions and specialised instruments. This can result in less tissue disruption and potentially faster recovery. However, not all patients are candidates for a minimally invasive approach, and the decision depends on the complexity of the case and surgeon expertise.
Risks and benefits of the artificial cervical disc surgery
As with any surgery, cervical disc replacement carries some risks. These may include infection, bleeding, nerve injury, vocal hoarseness (due to temporary nerve irritation), or difficulty swallowing. There's also a small risk that the artificial disc could move or wear down over time.
However, when performed on suitable candidates, the benefits can be significant. Many patients experience substantial pain relief and improved function. A key advantage over spinal fusion is the preservation of normal neck motion, which may reduce the likelihood of developing further disc problems at nearby spinal levels in the future.
Additionally, there is typically no need for prolonged immobilisation or bracing of the neck.
What to expect after the artificial cervical disc surgery
Recovery from cervical artificial disc replacement is often faster than traditional fusion surgery. Many patients are discharged the same day or within 24 hours. Neck movement is generally encouraged soon after surgery, though heavy lifting and strenuous activity are restricted for several weeks.
Most people return to light work within two to four weeks, though this depends on the individual’s occupation and overall health. Full recovery and return to more physical tasks may take up to three months. Unlike fusion, which limits movement at the treated segment, patients who undergo disc replacement usually retain a good range of motion in their neck.
