Cervical Disc Replacement

What it is

Instead of fusing the segment, the surgeon removes the disc and implants an artificial disc that preserves motion at that level³.

How it compares to ACDF

For appropriately selected patients, disc replacement has performed as well as or better than ACDF in high-quality studies. Pooled analyses of randomized trials show comparable or higher overall success, fewer secondary surgeries, preserved motion at the operated level, and lower rates of adjacent segment disease³. A systematic review out to longer follow-up found fewer repeat surgeries and adverse events with disc replacement, though some differences were statistically but not clinically large⁴. The preservation of motion and the roughly halved rate of adjacent-level problems are the main theoretical advantages. Not everyone is a candidate — significant arthritis, instability, or deformity may make fusion the better choice.

My own research on this question

Disc replacement is an area I have studied directly. My colleagues and I have published two meta-analyses in The Spine Journal: one comparing how different artificial disc designs perform against fusion¹, and one examining how industry funding affects the outcomes reported in disc replacement trials². That work shapes how I read the evidence and how I talk with patients about which operation fits them.