Neck pain can affect many parts of your life. It can make everyday activities hard, like turning your head in traffic, looking down at your phone or even getting comfortable in bed at night. Sometimes, the pain stays in your neck. Other times, it spreads to your shoulders, arms or hands.
Many people get better with rest, medication and physical therapy. But if symptoms don’t improve, surgery might be needed.
For many years, the most common surgery for neck disc problems has been spinal fusion. Today, another option may be available: cervical disc replacement.
“Cervical disc replacement is a surgery that removes a damaged disc and puts in an artificial one that lets the neck keep moving,” said Eric Arias, MD, a neurosurgeon at Banner Health. The procedure treats the source of nerve pressure while preserving motion in the spine.
Learn more about this minimally invasive surgery, how it differs from spinal fusion and see if you might be a good candidate.
Understanding the cervical disc
Your neck, also called the cervical spine, has seven small bones called vertebrae. Between most of these bones are soft cushions known as discs. These discs act like shock absorbers, helping your neck move smoothly and protecting the bones and nerves.
“Each disc has a tough outer layer and a softer center that allows flexibility,” Dr. Arias said. “Healthy discs help you bend your neck forward and backward, rotate your head and tilt it toward your shoulders. They also maintain the space for the nerves that exit the spine.”
Over time, discs can wear out, bulge or even tear. If a damaged disc presses on a nerve, it can cause a condition called cervical radiculopathy (a pinched nerve).
Signs of cervical radiculopathy include:
- Neck pain
- Tingling
- Numbness
- Weakness that spreads into the shoulders, arm or hand
When surgery may be recommended
Many people with neck disc problems get better without needing surgery. Spinal surgeons usually start with treatments like physical therapy, medication or activity changes. In some cases, steroid injections can help reduce swelling (inflammation) and ease nerve pain.
Spinal surgery might be recommended if symptoms do not improve or if nerve pressure becomes worse. The main goal of surgery is to remove the damaged disc and take pressure off the nerves or spinal cord.
The traditional approach: spinal fusion
For many years, the standard treatment for cervical disc issues has been anterior cervical discectomy and fusion. During this procedure, the surgeon removes the damaged disc and inserts a bone graft or implant between the vertebrae. Over time, the bones grow together and fuse into a single, solid segment.
Fusion surgery has benefited many people and remains a highly effective treatment. However, because the fused bones no longer move, it changes how the neck functions over time.
“When you fuse a level of the spine, that segment stops moving,” Dr. Arias said. “The levels above and below take on more motion to compensate for it.”
A newer option: Cervical disc replacement
Cervical disc replacement is different because it keeps the neck moving instead of stopping it. Instead of fusing the bones together, the surgeon replaces the damaged disc with an artificial one that allows movement.
During the surgery, the doctor makes a small cut in the front of the neck and takes out the damaged disc. Once the nerves or spinal cord are no longer under pressure, the surgeon places an artificial disc between the bones. This disc is made to move like a natural disc.
“The goal is to fix the nerve pressure while keeping the neck moving naturally," said Dr. Arias. “For the right patient, this can be a big advantage. It helps the neck work more like it normally should."
Potential benefits of cervical disc replacement
For certain patients, artificial disc replacement may offer several benefits:
- Maintains neck movement: Unlike fusion, an artificial disc allows the treated level to continue moving.
- Faster recovery: Many people regain movement quickly and go back to their normal activities sooner.
- Less stress on nearby discs: Fusion can cause increased wear and tear on the discs near the treated area. Since disc replacement keeps the spine moving, it may put less strain on other parts.
- No bone graft needed: Fusion often requires adding bone or hardware. Disc replacement usually does not.
Who may be a candidate?
Not everyone with neck pain is a candidate for cervical disc replacement. Your health care provider will consider several factors to determine the most appropriate surgery.
Cervical disc surgery may be considered if you:
- Have a herniated or damaged cervical disc
- Have single- or two-level degenerative disc disease (affects one or two vertebra)
- Have arm pain or nerve symptoms that haven’t improved with conservative treatment
- Have relatively healthy surrounding joints
“This surgery is often well-tolerated and successful for young people in good health and shape and free from age-related wear and tear,” Dr. Arias said. “It’s also a popular choice for athletes as it has a faster recovery time and preserves the motion of the neck.”
Disc replacement may not be recommended if you have:
- Severe arthritis in the spine
- Spine instability
- Advanced disc degeneration
- Advanced osteoporosis
- Allergies to certain metals
The procedure is not recommended for children and adolescents. If you are pregnant, you may be eligible after you have delivered your baby.
Your surgeon will review imaging tests like MRI or CT scans to help decide the best treatment option.
What recovery looks like
Artificial disc replacement is a minimally invasive surgery often performed in an outpatient setting. This leads to a shorter and easier recovery. It also does not reduce mobility.
“Many people return to pain-free living with the same range of motion they had before their neck condition started,” Dr. Arias said. “Your provider may suggest physical therapy to help restore strength and mobility.”
Full recovery times can vary. Many people notice significant improvement within six to 12 weeks.
Is disc replacement better than spinal fusion?
There is no single “best surgery” for everyone. Both options have a good track record for relieving nerve pressure and easing pain. Your spine specialist will explain the advantages and disadvantages of each choice. They will consider your diagnosis, overall health, condition of your spine and how many levels are involved.
When to talk with a specialist about neck pain
Occasional neck pain is common and often improves with conservative treatments. But see a health care provider if you experience:
- Neck and back pain lasting more than a few weeks
- Pain traveling down your arm
- Tingling or numbness in your hand
- Weakness in the arm or shoulder
- Trouble with balance or coordination
These symptoms may signal nerve or spinal cord compression. Getting checked out can help prevent symptoms from worsening.
Takeaway
Neck surgery has advanced in recent years. For many people, spinal fusion still remains a reliable and effective treatment. But cervical disc replacement is another option that might help keep your neck moving naturally.
If neck pain or arm symptoms are making it hard to do your daily activities, talk to a health care provider or a Banner Health specialist. They can help you find the right treatment to keep your neck healthy and moving for years.
