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.
 
 
 

If you are considering treatment options for cervical disc problems, you’ve likely heard about fusion surgery and newer alternatives. Let’s explore five important things you need to know about cervical artificial disc replacement (ADR) — a motion-preserving procedure that could change how you think about spine surgery.

ADR surgery is a procedure that removes a damaged, degenerative disc and replaces it with an artificial disc. The artificial disc is designed to preserve motion in your neck, treating conditions like cervical radiculopathy and myelopathy. This innovative approach is designed to help reduce pain, weakness and numbness while avoiding the stiffness that comes with traditional fusion surgery.

1. ADR Is Designed to Replicate Natural Biomechanics

Unlike fusion, which locks bones together, FDA-approved artificial discs are sophisticated devices engineered to mimic the biomechanics of a natural human disc.

Traditional fusion uses static spacers, plates and screws designed to stop motion entirely. Sophisticated cervical artificial disc replacement implant devices like the next-generation M6-C™ artificial cervical disc use medical-grade materials specifically chosen for their biocompatibility and longevity:

  • Titanium or cobalt chromium: These materials are used for the endplates that attach securely to the vertebrae.

  • Medical-grade polyethylene or ceramic: They are used for the inner core and allow smooth gliding and rotation.

The ball-and-socket design allows for six degrees of freedom — compression, extension, rotation and bending in multiple directions. This design acts as a shock absorber to protect the spinal cord while maintaining the natural movement patterns your neck was designed for. 

Unlike fusion, which transfers stress to adjacent levels, cervical disc replacement surgery distributes forces more naturally throughout your spine.

2. It Is a Minimally Invasive, Motion-Sparing Procedure

This procedure aligns with modern minimally invasive spine surgery principles, prioritizing tissue preservation and long-term spinal health.

One of the most significant advantages of artificial disc replacement is the peace of mind it provides. Knowing that your surgery was designed to minimize stress on the adjacent levels of your spine offers psychological relief that extends far beyond the operating room. 

Long-term studies show significantly lower reoperation rates for ADR patients — about 3% compared to 12.3% for fusion patients. This dramatic difference is because disc replacement procedures preserve the natural load distribution across spinal segments, preventing the accelerated wear that often affects levels above and below a fusion.

3. Strict Criteria Determine if You Are a Candidate

While cervical artificial disc replacement is highly effective for treating compressed nerves at levels like C5 and C6, proper patient selection is the single most important factor for a successful outcome.

The ideal candidate typically meets the following criteria:

  • Healthy facet joints: Because the artificial disc keeps the spine moving, the hinges of the spine, called facet joints, must be healthy. If a patient has severe arthritis in these joints, keeping them moving would cause continued pain.

  • Good bone quality: The artificial device needs strong bone to anchor into. Patients with severe osteoporosis may not have the bone density required to support the implant.

  • Absence of instability: The spine must be stable to handle the range of motion provided by the artificial disc.

  • Lack of bridging bone: Patients with extensive bony growths that have already naturally fused parts of the spine may not benefit from an attempt to restore motion.

Your surgeon will evaluate your specific anatomy using advanced imaging techniques, like magnetic resonance imaging (MRI) and computed tomography (CT) scans. This thorough assessment ensures that ADR surgery is an appropriate choice for your unique spinal condition, maximizing your chances for optimal outcomes.

4. Recovery Is Often Faster Than Fusion

Recovery times vary between patients, but individuals often return to recreational activities sooner than fusion patients. This is because there is no bone graft that needs to heal and fuse. Cervical artificial disc replacement recovery time is typically more predictable and allows for earlier mobility. Key advantages include:

Resuming Physical Activities Sooner

One reason patients choose ADR surgery over fusion is the desire to enjoy life again. For many, the goal is getting back to the golf course, the tennis court or playing with grandchildren without fear of stiffening up. The return to physical activity following a disc replacement follows a more natural progression because the spine isn’t permanently locked in place.

Unlike fusion patients who must wait months for bone healing before resuming full activities, disc replacement patients can gradually increase their activity levels as soft tissues heal, typically within six to 12 weeks. Reviews indicate exceptionally high return-to-play rates of 96% to 100% for athletes undergoing cervical disc replacement. This success rate reflects the procedure’s ability to keep your neck moving naturally while helping reduce pain and improve function. This allows you to return to the physical activities you love. 

Enhanced Peace of Mind

Beyond the physical benefits, there is a significant psychological advantage. Knowing that your surgery was designed to minimize stress on the adjacent levels of your spine can provide peace of mind. Patients can often engage in range-of-motion activities with more confidence, knowing they have chosen a solution that works with their body’s natural mechanics.

5. Long-Term Safety and Risks

Cervical ADR has established a strong safety profile and is now FDA-approved for use in up to two adjacent levels of the spine.

For patients with multiple-level cervical disease, two-level disc replacement in the neck offers an excellent alternative to multilevel fusion. Clinical trials support that two-level ADR is a safe and effective procedure.

The FDA approval for two-level procedures represents years of rigorous clinical testing and validates the long-term durability of these devices. This approval gives both surgeons and patients confidence in treating more complex spinal conditions while preserving natural motion.

Like any surgical procedure, cervical disc replacement has advantages and potential risks that should be carefully considered under your surgeon’s guidance.

Why You Should Get a Second Opinion

Don’t feel pressured to accept a fusion diagnosis without exploring all your options. Many patients benefit from seeking a second opinion to explore motion-preserving alternatives like cervical disc replacement surgery. Every spine condition is unique, and what works best for one patient may not be optimal for another.

At DISC, our goal is to find the least invasive solution that yields the best long-term result for your specific situation. Our patient-centered approach means you receive the most appropriate treatment for your lifestyle and physical needs.

Take the Next Step With Confidence

Cervical artificial disc replacement is a significant advancement in spine surgery, offering a viable motion-preserving alternative to traditional fusion for appropriately selected patients. This procedure addresses the root cause of cervical disc problems while maintaining your spine’s natural movement patterns.

DISC has extensive experience with artificial disc replacement procedures and the expertise to help determine if you are a candidate for this innovative treatment. If you are suffering from cervical disc problems and want to explore motion-preserving alternatives to fusion, schedule an appointment at one of our Arizona locations to discuss whether ADR surgery is right for you.

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