The standard surgical procedure for a cervical ADR requires an anterior (from the front) approach to the cervical spine. This anterior surgical approach is the same as that used for an anterior cervical discectomy and fusion (ACDF) surgery to remove the damaged disc. A typical single-level cervical ADR surgery, described below, takes a little more than an hour to perform.

Preparing for Cervical Disc Replacement Surgery

Before having cervical disc replacement surgery, the surgeon typically requests the following of the patient in the weeks leading up to the procedure:

  • Quit smoking and/or other tobacco products. Smoking is known to raise the risk for surgical complications, such as infection, as well as have a detrimental effect on bones and the healing process.

    Watch: Quitting Smoking: A Must for People with Back Pain Video

  • Review medications. Some medications may need to be temporarily stopped, or dosages reduced, in the days leading up to and/or during the cervical ADR procedure. For example, the surgeon would need to know about any medication that might increase the risk for excessive bleeding, negatively interacting with anesthesia, or inhibiting bone healing. This list can also include supplements.
  • Take a physical exam. The patient must be evaluated for overall health, including blood tests, to ensure that he or she would be able to tolerate the surgery and the recovery process.

For surgeries that are scheduled in the morning, no food or drink is allowed after midnight (except for small amounts of water up to 2 hours before surgery). In general, no eating is allowed 8 hours prior to the surgery.


Step-by-Step Process for Cervical Disc Replacement

A single-level cervical ADR surgery commonly involves the following steps:

  • The patient lies face up on a table. General anesthesia is applied so the patient goes to sleep (becomes unconscious) and does not feel pain or discomfort during the procedure.
  • A 1- to 2-inch incision is made in the front of the neck.
  • The affected disc is removed, as are any disc fragments or osteophytes (bone spurs) that are pressing on a nerve root or the spinal cord.
  • The disc space is restored to its normal disc height to help relieve pressure on the surrounding nerves.
  • Using live x-ray imaging (fluoroscopy) for visual guidance, the artificial disc device is placed in the prepared disc space. More than one artificial disc size may be tried before the surgeon decides on the best fit. The specifics of how the artificial disc is implanted can vary depending on the type of disc.
  • After the artificial disc is placed and attached to the 2 adjacent vertebrae (above and below), the incision is sewn up.

See Cervical Artificial Disc Replacement Technologies

After the surgery is completed, the patient may be taken to an observation room for an hour or two while the medications wear off.

Dr. Jeffrey Goldstein is an orthopedic surgeon at NYU Langone Orthopedic Hospital. He has been a practicing spine surgeon for more than 20 years, specializing in minimally invasive spine surgery and artificial disc replacement.