Surgical Procedure for Cervical Disc Replacement

The standard surgical procedure for a cervical disc replacement requires an anterior approach (from the front) to the cervical spine. This surgical approach is the same as that used for an anterior cervical discectomy and fusion (ACDF) operation.

The cervical ADR surgery will typically include the following:

  • An incision is made in the front of the neck.
  • The affected disc is completely removed, as are any disc fragments or osteophytes (bone spurs) that are pressing on the nerve or spinal cord.
  • The disc space is distracted (jacked up) to its prior, normal disc height to help decompress (relieve pressure) on the surrounding nerves. Restoring the original disc height is important; when a disc becomes worn out, it will typically shrink in height, which can contribute to the pinching of the nerves in the neck.
  • Using X-rays or fluoroscopy as guidance, the artificial disc device is implanted into the prepared disc space.

Postoperatively, the patient typically can go home within 24 hours with minimal activity limitations.

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Potential Risks and Complications

The potential complications of an artificial disc are in general similar to an anterior cervical discectomy and fusion (ACDF) and may include:

  • Infection
  • Blood loss
  • Nerve injury or paralysis
  • Failure to relieve the patient's pain and symptoms
  • Need for further surgery
  • Reactions to the anesthesia
  • Spinal fluid leak
  • Voice change, difficulty swallowing, difficulty breathing

While these complications can be severe, they are rare occurrences.

In theory, the artificial disc has some of the same potential complications as a total hip and knee replacement. An arthroplasty is a mechanical device and will wear out over long periods of time. The implant bearing may consist of a metal-on-polyethylene (plastic polymer) or a metal-on-metal bearing, depending on the specific implant. As a result, small particle debris may react with the body; however, few cases have been reported in the literature.

Laboratory and animal studies for some of the devices have shown that, after simulating ten years of wear, only minimal disc wear occurs and the materials appear to be well tolerated over time. At the time of this article, wear-related complications have only rarely been reported in patients undergoing cervical disc replacement. However, as cervical artificial disc replacement is a relatively newer procedure, there is still potential for longer-term, unknown risks to occur over time.