What to Know About Cervical Disc Replacement Surgery

Cervical disc replacement (CDR) is a surgical procedure for replacing a damaged disc between the vertebrae in your neck with an artificial disc. The goal is to improve mobility through the neck and reduce pain. CDR is sometimes called anterior cervical disc arthroplasty (ACDR) or total disc replacement (TDR). CDR is also an alternative to spinal fusion surgery.

This article will cover the important need-to-know details, including signs of disc degeneration disease (DDD), who is eligible for replacement surgery, what happens during the procedure, how to prepare and what to expect regarding recovery timelines, possible risks and complications, and outcome.

Who’s Eligible for Cervical Disc Replacement?

If cervical disc degeneration is causing neck pain and arm pain, and you're between the ages of 18 and 60 with disc degeneration disease, you may be eligible for cervical disc replacement. Your healthcare provider will administer tests to determine whether this procedure makes sense for you.

Cervical Disc Degeneration

Specific criteria for cervical disc replacement include:

• Disc degeneration in at least one cervical spine disc that is herniating and compressing nerve roots, causing arm pain
• No improvement from having already tried first-line treatments such as physical therapy, pain medication, or neck bracing
• Health meets eligibility criteria for undergoing surgery with no signs of infection, osteoporosis (brittle bone disease), arthritis, or osteomalacia (bone softening)
• No known allergies to metals used in artificial discs

The American Association for Neurological Surgeons states this procedure is not recommended for people who have had spinal fusion surgery or surgical procedures in the past.

Disc Degeneration Symptoms

The main symptom of disc degeneration is pain. A range of physical sensations such as radiating pain, tingling, and numbness can be expected.

Disc degeneration disease symptoms:

• Pain radiating to the arms, hands, buttocks muscle, and/or thigh muscles
• Pain that worsens when sitting due to increased pressure on your discs in this position
• Pain that worsens when doing certain movements like lifting, bending, or twisting
• Pain that improves when doing certain movements like walking, running, standing, or lying down
• Periods of pain worsening and lasting from a few days to a few months before improving
• Numbness and tingling in the hands and feet
• Leg muscle weakness
• Difficulty lifting the front part of your foot when you walk (foot drop) 
• Neck pain
  

What Happens During Cervical Disc Replacement Surgery?

The average hospital stay for this procedure is a few days. A person will be under anesthesia during disc replacement surgery. Depending on the disc location, a small incision will be made so the surgeon can access the front of the spine through the neck area or abdomen. The disc will be removed and replaced with an artificial one. Any collapse of other discs will also be repaired at this time.

Disc Replacement vs. Anterior Cervical Discectomy and Fusion (ACDF)

A disc replacement is different from another procedure called an anterior cervical discectomy and fusion or ACDF. In a replacement, the affected disc is entirely removed and replaced by an artificial disc. In the ACDF procedure, degenerated, herniated, or protruding cervical discs are removed, but the remaining discs are also reconstructed by fusing them.

How to Prepare for Cervical Disc Replacement Surgery

Your surgeon will go over in detail how to prepare and any special instructions to follow for your cervical disc replacement surgery. Experts recommend preparing by scheduling a presurgical physical exam, if possible, and discussing any current medications and supplements with your surgeon.

Before surgery, it is also recommended to avoid or quit smoking as smoking interferes with the body's ability to heal and increases your risk of infection. You will also be advised to avoid eating or drinking for a period of time before surgery, usually at midnight the night before.

Cervical Disc Replacement Recovery

Many factors influence a person's recovery after surgery. However, experts say the general length of time for recovery after cervical disc replacement is six to eight weeks. The recovery process may include increasing activities such as walking or stretching at your own pace for the first month.

Then, your surgeon or healthcare provider may recommend a strengthening exercise program and notify you when you can resume other physical activities, including sports.

Cervical Disc Replacement Complications and Risks

Cervical disc replacement is a relatively new procedure in the United States, and has been deemed safe. Every surgical procedure carries some risk, though. The following complications and risks can occur with this procedure.

• Allergic reaction to artificial disc materials or surgery-related infection
• Blood vessel problems or bleeding problems (could require blood transfusion)
• Degeneration of nearby discs
• Implants bend, break, or move
• Incision problems
• Loss of range of motion at the treated cervical level
• Numbness or tingling in arms, hands, legs, and feet
• Discomfort and pain
• Paralysis
• Anesthesia side effects
• Spinal cord or nerve damage
• Spinal fluid leakage
• Dura tissue tears (a layer of tissue covering the spinal cord)
• Death

Consulting with your surgeon is encouraged if you have concerns about risks and complications from disc replacement surgery.

What’s the Outlook After Cervical Disc Replacement Surgery?

Cervical disc replacement surgery outlook includes reduced or resolved pain symptoms and increased mobility along with preserving the health of other spinal discs. Estimates suggest discs tend to last 40 or more years, so while they are long-lasting, some people may need a replacement depending on age of first surgery.

Summary

Cervical disc replacement surgery involves a procedure in which a degenerated or herniated (ruptured) disc is removed and replaced with an artificial disc. The procedure replaces discs damaged by disc degeneration disease but not everyone with it is a suitable candidate. The main symptom of disc degeneration disease is pain, which the procedure resolves.

Risks and complications include general surgery risks and specific risks associated with spinal surgery. Recovery can take between six to eight weeks. Outlook is good with reduced pain and improved mobility.