When a cervical disc wears out and surgery is needed, the default operation for decades has been ACDF: remove the disc and fuse the two vertebrae. Artificial disc replacement asks a reasonable question: if a hip or knee can be replaced with a moving implant, why lock a neck joint solid?
What it treats
Cervical degenerative disc disease or disc herniation causing arm pain, numbness, or weakness that has not responded to conservative care, at one or two levels.
How it works
Through a small incision at the front of the neck, the worn disc is removed, taking pressure off the nerves. Instead of packing the space with bone graft and plating it solid, the surgeon inserts an implant with two metal plates and a mobile bearing core. The implant restores the disc's height and keeps the segment moving.
Recovery
Typically outpatient or one overnight stay. Because there is no fusion to wait for, activity restrictions lift much sooner than with ACDF; many patients are back to normal activity in weeks. FDA-approved cervical disc implants now have long-term follow-up data behind them.
Who it's for, and who it isn't
Good candidates have disease at one or two levels, adequate bone quality, and facet joints healthy enough to keep moving. Severe facet arthritis, significant instability, or osteoporosis push the decision back toward fusion. This is precisely the trade-off worth a second opinion, since the long-term stakes, including adjacent segment disease, differ so much between the two operations.