Motion Preservation
Artificial Disc Replacement (ADR)
A Motion-Preserving Alternative to Spinal Fusion
When spinal discs wear out or herniate, they can compress nerves and cause pain, numbness, or weakness. Traditionally, fusion surgery has been used to stabilize the spine, but this permanently eliminates motion at the treated level. Artificial disc replacement (ADR) offers a modern alternative—relieving pain while preserving natural movement. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS specializes in cervical and lumbar artificial disc replacement, carefully selecting candidates who benefit most from motion-preserving implants.
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What Is Artificial Disc Replacement?
In simple terms: The damaged disc is removed and replaced with an artificial disc that restores height and motion between vertebrae.
Scientifically: ADR (also called total disc arthroplasty) involves anterior exposure, complete discectomy, endplate preparation, and implantation of a prosthesis engineered to replicate spinal biomechanics, preserving sagittal and coronal motion and reducing adjacent segment degeneration.
Conditions Treated
Degenerative disc disease
Herniated discs not responsive to conservative care
Radiculopathy (nerve root compression with pain/numbness/weakness)
Cervical myelopathy in select cases
Single- or two-level disc disease without instability
Who Is a Candidate?
Ideal candidates:
Younger or middle-aged patients
One or two diseased disc levels in the neck or low back
No severe arthritis or instability
Healthy bone density
Not candidates if:
Multi-level instability or deformity
Severe facet arthritis at the target level
Osteoporosis or poor bone quality
Prior fusion at adjacent levels
The Artificial Disc Replacement Procedure: Step by Step
Plain-English Overview
Anesthesia & positioning: You’re asleep under general anesthesia.
Anterior approach: Incision made in front of the neck (cervical) or abdomen (lumbar).
Disc removal: The diseased disc and bone spurs are removed.
Nerve decompression: Spinal cord and/or nerve roots are freed.
Artificial disc placement: The implant is sized and placed between vertebrae.
Closure: The incision is closed; many patients go home the same or next day.
Surgeon-Level Detail
Exposure: Smith-Robinson cervical approach or anterior lumbar retroperitoneal exposure with vascular assistance.
Discectomy: Complete annulotomy, nucleus/annulus removal; PLL resection and osteophytectomy as indicated.
Endplate preparation: Endplates milled for prosthesis; cortical integrity preserved to avoid subsidence.
Implantation: Artificial disc inserted under fluoroscopy; restores disc height, lordosis, and motion.
Closure: Hemostasis; layered closure; drain rarely needed.
Benefits of ADR
Maintains motion at treated level
Reduces risk of adjacent segment disease compared to fusion
Effective pain relief for arm, leg, or back pain due to disc disease
Shorter recovery compared to fusion
Long-lasting results with modern implants
Risks & Limitations
Implant wear, migration, or subsidence (rare with proper placement)
Infection, bleeding, nerve injury (rare with neurosurgical precision)
Not suitable for severe arthritis or deformity cases
Long-term durability still being studied (20+ year data available for cervical ADR)
Recovery Timeline
Day 0–1: Walking within hours; many go home in 24–48 hours
Weeks 1–2: Soreness; gradual return to light activities
Weeks 2–6: Desk work and driving resumed; limited restrictions
6–12 weeks: Begin structured physical therapy; mobility restored
3–6 months: Most daily activities resumed comfortably
12 months: Continued follow-up to ensure implant stability and function
Why Choose Desert Spine and Pain?
Expert neurosurgeon: Dr. Greenwald is highly skilled in both cervical and lumbar ADR
Comprehensive approach: We offer fusion, ADR, or hybrid surgeries depending on patient needs
Advanced implants: State-of-the-art artificial discs with excellent long-term data
Patient-first philosophy: Careful evaluation and personalized treatment to ensure success
Frequently Asked Questions
How is ADR different from fusion?
Fusion eliminates motion at the treated level. ADR preserves mobility while relieving pressure.
How long do artificial discs last?
Most are designed for 10–20+ years. Cervical ADR has strong long-term success rates in published studies.
Will ADR cure my back pain?
ADR is best for disc-related pain and nerve symptoms. Pure back pain from arthritis may not improve as much.
Who is the ideal patient for ADR?
Younger, active patients with 1–2 level disc disease, no instability, and healthy bone quality.
How does Desert Spine and Pain perform ADR differently?
We emphasize precision patient selection, neurosurgical expertise, and advanced implants to ensure lasting results.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If you’re living with chronic neck or back pain due to degenerative disc disease, Artificial Disc Replacement (ADR) may be an excellent solution. Dr. Greenwald and his experienced team will carefully evaluate your condition, explain your treatment options, and determine whether ADR is the best approach for your spine. Every step you take toward advanced, motion-preserving care brings you closer to comfort, flexibility, and renewed quality of life. Schedule your consultation today and let Dr. Greenwald help you restore movement and live pain-free.
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Over 30 Years Experience in Orthopedic & Neuro Spine Surgeries.
Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon specializing in Artificial Disc Replacement (ADR), a state-of-the-art procedure that relieves pain caused by damaged or degenerated spinal discs while preserving natural motion. Unlike traditional spinal fusion, ADR replaces the diseased disc with a biomechanically engineered artificial disc that mimics the movement and function of a healthy one. Dr. Greenwald performs both cervical and lumbar disc replacements, using advanced imaging and minimally invasive techniques to ensure precise placement and optimal outcomes. His expertise allows patients throughout South Florida to experience reduced pain, quicker recovery, and long-term spine health without losing flexibility or range of motion.
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