Artificial cervical disc replacement is newer technology. It is a surgery that is performed in substitution of anterior cervical discectomy and fusion (ACDF). Rather than replacing the removed disk with a spacer or bone graft in an attempt to fuse the segment, we replace the removed disk with a device that will maintain motion. Much of this new technology is modeled after hip and knee replacement prosthesis. We can show you a model of the artificial disk which is made out of a combination of metal (cobalt chrome) and plastic (polyethylene).
A certain subset of patients with a pinched nerve in the neck that have failed all non-operative treatment options would be candidates for this type of surgery. We will take into account the patient’s age, the amount of arthritis in the neck, and other factors to determine if a patient is a candidate for this type of surgery versus the more commonly performed ACDF. The surgery itself and the risks of the surgery compared to ACDF are very similar. The postoperative course and general restrictions are also very similar to ACDF. The main potential advantage of artificial disk replacement compared to ACDF is a phenomenon known as adjacent level degeneration. Adjacent level degeneration is something we want to avoid but it can occur in certain patients after a cervical fusion.
It is thought that the stiff fused segment can create extra stresses on the segments above and below the fusion. If enough stress occurs and the adjacent segment develops arthritis or a disk bulge then further surgery may be needed. It is thought that the artificial disk replacement surgery which maintains motions will hopefully decrease the incidence of adjacent level degeneration. We can do the artificial disk replacement on 1 or 2 levels depending on what the patient needs.
The ideal patient for this relatively new technology is a younger patient with minimal neck arthritis that may have a disk herniation and a pinched nerve.