Medically reviewed by Dr. David L. Greenwald, MD, FAANS, FACS — dual board-certified spine surgeon & neurosurgeon. Last reviewed October 2026.

For the right patient, a worn or herniated disc doesn't have to be fused — it can be replaced. Motion-preservation surgery swaps the damaged disc for an artificial one that keeps the segment moving naturally, relieving pain while protecting the discs above and below from extra stress.

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What Is Motion-Preservation Spine Surgery?

Motion-preservation spine surgery is a family of procedures that relieve nerve and disc pain without permanently locking the spine in place. Instead of fusing two vertebrae together — the traditional approach — the surgeon removes the damaged disc and replaces it with an artificial disc designed to flex and bend much like a healthy natural disc. The segment keeps moving, and because it keeps moving, it doesn't force the neighboring discs to absorb the extra workload that a fused level would pass along.

The best-known of these procedures is artificial disc replacement (also called total disc replacement, or ADR), which can be performed in the neck (cervical) or lower back (lumbar). At Desert Spine and Pain, motion preservation is offered as part of a complete spine surgery program — and, like every operation here, it's considered only after conservative care and interventional pain procedures have been given a fair chance. Because Dr. Greenwald is both a spine surgeon and a neurosurgeon, the disc, the bone, and the delicate nerves around them are all handled by one expert.

Our Motion-Preserving Procedures

Most patients searching for disc replacement don't yet know which version they need — that's exactly what the consultation is for. These are the motion-preserving procedures we offer, each matched to a specific problem:

Motion Preservation vs. Fusion

This is the heart of the decision, so it's worth being straight about it. Spinal fusion permanently joins two or more vertebrae into a single solid unit. It's one of the most reliable operations in spine surgery, and for the right problem it's the correct choice. The trade-off is that the fused segment no longer moves — and the discs directly above and below it have to take on the motion the fused level used to share. Over years, that added load can accelerate wear at the neighboring levels, a pattern surgeons call adjacent-segment degeneration.

Motion preservation is built to address exactly that trade-off. By replacing the bad disc with an artificial one instead of fusing the segment, the operation:

• Preserves natural movement at the treated level, so you keep more of the bending and rotation you had before.
• May reduce stress on the neighboring discs, which is the main theoretical advantage over fusion — the reduced risk of adjacent-segment problems down the road.
• Often allows a quicker early recovery, because there's no bone graft that has to knit together over months before the segment is stable.

Honesty matters here, and it's a point Dr. Greenwald makes with every patient: fusion is still the right answer for many people. If a segment is unstable, if there's a fracture, significant arthritis in the small facet joints, poor bone quality, or a slipped vertebra, an artificial disc can't do its job — and a fusion is both safer and more durable. Motion preservation also has a shorter long-term track record than fusion, which has decades of outcome data behind it. The goal is never to avoid fusion for its own sake; it's to use the right procedure for your spine. Because Dr. Greenwald performs both, his recommendation isn't shaped by which operation he happens to offer.

When Is Motion Preservation an Option?

Artificial disc replacement works beautifully for the patient whose anatomy suits it — and not at all for the patient whose anatomy doesn't. In general, you may be a candidate if:

• Your pain comes from the disc itself. Disc-related neck and arm pain, or back and leg pain, from a herniated disc or degenerative disc disease — not from arthritic joints or instability.
• Your facet joints are still healthy. The small joints at the back of each segment need to be in good shape to carry motion safely after the disc is replaced.
• Your alignment and bone quality are good. A well-aligned spine with solid bone holds an artificial disc securely; significant osteoporosis or deformity argues against it.
• The problem is limited to one or two levels. Focused disc disease is far more suited to motion preservation than widespread, multi-level degeneration.

Younger, active patients with a single worn or herniated disc are often ideal candidates. But candidacy is decided by your imaging and exam, not by age alone — and for some patients the honest recommendation will be fusion. The only way to know which camp you're in is a thorough evaluation.

Keep the Spine Moving When You Can

Surgery of any kind is never our first step. The large majority of neck and back problems improve with conservative care and interventional pain procedures, and we exhaust those first. When an operation truly is warranted, the question becomes which operation — and when a patient is a good candidate, replacing the disc instead of fusing it preserves natural movement and may protect the rest of the spine. Because Dr. Greenwald performs both fusion and disc replacement, he can give you a genuinely balanced recommendation rather than steering you toward the one procedure he offers. All surgical procedures are performed at an accredited affiliated surgical facility.

What to Expect — From Consultation to Recovery

Deciding on disc replacement should never feel rushed or one-sided. Here's how the process works at Desert Spine and Pain:

• Consultation & imaging. Dr. Greenwald reviews your history, examines you, and studies your MRI or CT to confirm the pain is coming from the disc — and that your facet joints, alignment, and bone quality can support an artificial disc.
• An honest recommendation. You'll hear whether motion preservation is genuinely the best option for your spine, or whether fusion — or a less-invasive step first — is the smarter choice. If disc replacement isn't right for you, we'll say so.
• The procedure. Your operation is performed by Dr. Greenwald at an accredited affiliated surgical facility, using the least-invasive approach that will fully address the problem. The damaged disc is removed and the artificial disc is positioned in its place.
• Recovery & follow-up. You're given a clear, personalized recovery plan and seen in follow-up to make sure you're healing well and getting back to the activities you love.

Recovery & Getting Back to Life

One of the appeals of motion preservation is that early recovery is often quicker than after a fusion, because there's no bone graft that has to fuse solid over months before the segment is stable. Many patients are up and walking soon after surgery and ease back into light activity within a few weeks, with a gradual return to fuller activity over the following weeks as comfort allows. Cervical (neck) disc replacement and lumbar (lower-back) disc replacement follow somewhat different timelines, and your exact plan depends on your procedure, your job, and your goals. Whatever the operation, you'll leave with specific instructions and a recovery timeline built around your life — and Dr. Greenwald will be clear about what to avoid early on so the artificial disc settles in properly.

Insurance, Out-of-Network & Cost

We welcome out-of-network patients of every kind and you don't need a referral to be seen. Our team verifies your coverage and explains any out-of-pocket costs before anything is scheduled, so there are no surprises. Because many of our patients come to us after a car accident or injury, we also coordinate closely with personal-injury attorneys and offer 24/7 concierge support for accident-related spine care.

Proudly Serving the Greater Phoenix, Arizona Area

Why Choose Our Disc Replacement Surgeon in Phoenix

Your surgery is performed by a dual board-certified spine surgeon and neurosurgeon who offers both fusion and motion-preserving disc replacement — so your plan is driven by what's best for your spine, not by a single technique. We welcome out-of-network patients, require no referral, and coordinate with personal-injury attorneys.

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Motion-Preservation Surgery: Frequently Asked Questions