What it is
Cervical disc arthroplasty (CDA) — also called cervical disc replacement — uses the same anterior approach as ACDF: a small incision at the front of the neck, removal of the diseased disc, and decompression of the nerve or cord. The difference is what goes into the disc space: instead of a fusion graft and plate, an artificial disc implant is placed that preserves motion at the treated level.
Why motion preservation matters
Fusion eliminates motion at the treated level, which is its purpose and its limitation. Over years, adjacent levels may experience increased stress from compensating for the fused segment — a phenomenon called adjacent segment disease. Whether fusion directly causes adjacent segment degeneration or simply unmasks pre-existing vulnerability is debated, but cervical disc arthroplasty was developed in part to avoid this potential downstream consequence.
Long-term studies comparing ACDF to CDA show similar decompression outcomes, with CDA showing lower rates of adjacent segment reoperation at 7–10 year follow-up in some series.
Who is a good candidate
Not everyone with a cervical disc herniation is a candidate for arthroplasty. CDA is most appropriate for:
- One- or two-level disease with soft disc herniation
- Good bone quality and preserved disc height
- No significant facet joint arthritis at the treated level (which would negate the benefit of motion preservation)
- No cervical instability
Patients who are candidates for fusion at all levels, those with significant deformity, or those with three or more levels typically proceed with ACDF. The choice is individualized based on anatomy, imaging, and patient goals.
What to expect
Recovery after CDA is similar to ACDF — most single-level patients go home the same day or after one night. Motion at the treated level is expected to be maintained, though the range varies by individual and implant design.