5 Key Points to Understand About Cervical Artificial Disc Replacement (ADR)

March 4, 2022
BY Nima Salari, M.D. FAAOS
Dr. Salari is a Board-Certified, Fellowship-Trained Orthopedic Spine Surgeon with specialized training in the operative and non-operative treatment of pathologic conditions affecting the spine. He specializes in ultra-minimally invasive endoscopic spine surgery and cervical artificial disc replacement.

Cervical artificial disc replacement or cervical total disc arthroplasty is an innovative surgical procedure that removes a damaged degenerative disc and replaces it with an artificial disc. The artificial disc was designed to preserve motion in your neck. The cervical disc replacement treats neck conditions such as cervical radiculopathy and a cervical herniated disc. This procedure relieves a compressed spinal nerve (radiculopathy), causing pain, weakness, numbness, or tingling in the neck, arms, and hands. 

Cervical disc arthroplasty avoids spinal fusion surgery in the neck. The fusion alternative surgery preserves neck mobility and minimizes future degeneration at adjacent spinal levels and possible future need of surgery. The surgery is like an anterior cervical discectomy and fusion (ACDF). However, instead of fusing the spine, an artificial disc preserves neck movement.

1. Minimally Invasive Outpatient Surgery

recent study looked at the outcomes for a single-level cervical total disc replacement performed in an inpatient hospital or outpatient surgical center. The study found no significant differences between the two groups for 30-day complications, readmission, and reoperation rates. Outpatient surgery, unlike inpatient, does not need an overnight stay in the hospital. In addition, ADR patients in the outpatient center have higher satisfaction scores and reduced hospital-related costs.

2. Artificial Disc Replacement Addresses Cervical Radiculopathy and Stenosis

One or more sources can cause pain in your spine. It could be a pulled muscle or possibly arthritis. The disc between the vertebrae in your neck can also become damaged and painful. Knowing which one is causing the pain will help diagnose and select the most effective treatment option.

Model showing irritated nerves in the spine

The most common causes of neck pain for artificial disc replacement surgery are:

Cervical radiculopathy

Commonly called a “pinched nerve,” happens when an exiting nerve branching off the spinal cord becomes compressed or irritated. It can be caused by bone spursforaminal stenosis, or herniated disc. Symptoms of a pinched nerve are usually felt radiating into the shoulders and arm and numbness and muscle weakness.

Herniated disc

Where a disc has developed a weakness and tears allowing a portion of the inner disc to protrude or push out into the spinal canal

Cervical stenosis

A condition in which the spinal canal has narrowed and become too small for the spinal cord and nerve roots. Cervical stenosis can be caused by arthritis bone growth, thickening of the ligamentum flavum above the spinal cord, or ligaments below the spinal canal turning into bone.

Cervical myelopathy

A neck condition where the spinal cord is squeezed or compressed by a herniated disc or boney lamina overgrowth.


3. Artificial Disc Replacement Does Not Treat Facet-related Pain

An artificial disc replacement, a motion-preserving surgery, is not clinically indicated for facet-related pain. The facets and cervical disc are what allow movement. A cervical spine fusion may be a better surgery to prevent movement of the facet by fusing the two vertebrae. No facet movement reduces pain.

Cervical facet joint pain is a pain in the neck. It means that the joints in the neck area have become inflamed or injured. Pain is felt when patients turn their neck side to side or up and down. The facets in the neck are in constant motion with repetitive movement and can become worn down over time. Also, severe trauma and injury like whiplash can cause degenerative arthritic changes in the facet joints.  


4. Reduces the Chance of Adjacent Segment Breakdown and Additional Need for Surgery

Because the artificial disc is a motion-preserving surgery, it restores movement in the neck, unlike a cervical spine fusion. By restoring movement, the patient has less stress on the spine. However, because their vertebrae are fused at one level, cervical spine fusion patients have additional pressure on the spine above and below the fusion. The artificial disc can significantly reduce the risk of future spinal degenerative disc disease.

In a recent study, patients undergoing an artificial disc replacement (ADR) reduced the risk of additional future spine surgery. For patients who had a one-level ADR at the seven-year follow-up, only 3% of ADR had additional surgery, whereas 12.3% of ACDF patients had further surgery. For patients with a two-level ADR versus patients with a two-level ACDF at seven years post-surgery, 4.4% ADR and 16.2% ACDF needed additional surgery.


5. FDA-Approved Up to Two Consecutive Cervical Levels

There are currently a few medical devices approved for a two-level cervical artificial disc replacement surgery (ADR). For patients with multiple-level spinal disc disease, this is an excellent opportunity to see if they are a good candidate for ADR surgery.

Recent studies have compared the gold standard of cervical spine surgery – anterior cervical discectomy and fusion (ACDF) to artificial disc replacement (ADR). The two-level ADR was superior to that of the ACDF surgery. The overall patient satisfaction rate was 85.9% with ADR and 73.9% with ACDF patients.



Artificial Disc Replacement (ADR)


Anterior cervical discectomy and fusion (ACDF)


Choose a Spine Fusion Alternative Surgery – Cervical Artificial Disc Replacement in Phoenix, AZ

A spine fusion is not always the best solution for patients with neck pain. A cervical artificial disc can be an excellent alternative to spine fusion surgery.  At DISC, our expert spine surgeons have been involved with artificial disc replacement or total disc arthroplasty research and clinical studies for over ten years. Our world-renowned orthopedic spine specialists in Phoenix, AZ, work with patients to treat complex spine conditions, including those who have failed previous surgical treatment.


Get a Second Opinion

Get a second opinion if your pain is chronic, affecting your quality of life, and you were told you need a cervical spine fusion. Our surgeons routinely offer patients a second opinion to evaluate and provide the least invasive yet most effective treatment options. DISC offers a complete range of nonsurgical, ultra-minimally invasive, motion-preserving, and minimally invasive solutions for patients suffering from painful neck and back conditions. 

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