Discectomy Procedures
An anterior cervical discectomy with disc replacement is a modern alternative to fusion. Instead of fusing two bones together after removing a damaged disc, the disc space is restored with an artificial disc implant that allows continued motion. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS carefully evaluates patients to determine whether disc replacement is the right choice. For the right patient, this procedure can relieve pain and pressure while maintaining neck mobility.
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In simple terms: We remove the damaged disc in the neck and replace it with a motion-preserving artificial disc instead of fusing the bones.
Scientifically: Cervical disc arthroplasty involves anterior cervical exposure, microsurgical discectomy, decompression of neural elements, and implantation of a mechanical prosthesis designed to replicate physiologic disc kinematics, preserving flexion, extension, lateral bending, and rotation.
Cervical radiculopathy from a herniated or degenerated disc
Cervical myelopathy (spinal cord compression, in select cases)
Degenerative disc disease at one or two levels
Patients who failed conservative treatments (PT, medications, injections)
Best candidates:
Younger, active patients
1–2 levels of disc disease
No severe arthritis or deformity
No instability or need for multi-level fusion
Not ideal for:
Severe spondylosis/arthritis
Spinal instability or deformity
Osteoporosis
Multi-level disease beyond 2 levels
Anesthesia & positioning: You’re asleep under general anesthesia, lying on your back.
Small incision: A 1–2 inch incision is made in the front of the neck.
Disc removal: The damaged disc and bone spurs are removed.
Nerve decompression: Spinal cord and nerve roots are freed.
Artificial disc placement: An artificial disc is placed in the disc space, restoring motion.
Closure: The incision is closed; patients often walk the same day.
Exposure: Smith-Robinson anterior approach with blunt dissection to prevertebral fascia.
Localization: Fluoroscopy ensures correct level.
Discectomy: Microsurgical annulotomy, nucleus removal, posterior longitudinal ligament resection as needed.
Decompression: Osteophyte removal with drill/Kerrisons; confirm free neural elements.
Disc replacement: Endplates prepared precisely; trialing performed; prosthesis (metal/polymer or metal-on-metal design) implanted under fluoroscopy.
Closure: Irrigation; layered closure with absorbable sutures; drain rarely needed.
Preserves motion at the treated level
Reduces stress on adjacent discs (lower risk of adjacent segment disease compared to fusion)
Small incision, outpatient or 1-night stay
Reliable relief of arm pain, numbness, and weakness
Faster return to activity than fusion in many cases
Difficulty swallowing (temporary dysphagia)
Hoarseness (recurrent laryngeal nerve irritation)
Implant-related complications (migration, wear, or mechanical failure—rare)
Not suitable for severe arthritis or instability
Fusion may still be required in some cases if disc replacement fails
Day 0: Walking same day; many patients go home within 24 hours
Weeks 1–2: Mild neck/throat soreness; gradual return to light activity
Weeks 2–6: Desk work and driving usually resumed
6–12 weeks: Begin structured physical therapy for strength and posture
3–6 months: Full activity for most patients; disc mobility preserved
12 months: Continued monitoring with X-rays to confirm implant position
Motion-preservation expertise: Dr. Greenwald is highly trained in both fusion and artificial disc replacement
Conservative-first philosophy: Surgery only when conservative options fail
Personalized care: Careful evaluation to decide between ACDF and disc replacement
Advanced technology: State-of-the-art implants and precision microsurgery
Disc replacement preserves motion at the treated level, while ACDF fuses the bones together. Both relieve nerve compression effectively.
Yes. Complications are rare, and implants are FDA-approved and studied extensively.
No. The artificial disc is designed to preserve normal motion.
Studies suggest durability for 10–20+ years, but long-term data is still evolving.
We carefully select patients who will truly benefit, ensuring the safest, most effective outcome while avoiding unnecessary fusion.
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Conditions ,Treatments Surgery &Wellness
October 06, 2025•0 min read
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