Cervical Disc Replacement (Artificial Disc)

Most neck and arm pain from a slipped disc settles without surgery. When an operation is needed, cervical disc replacement takes out the damaged disc and puts in an artificial one, so your neck keeps its movement. It suits some people and not others, and we'll tell you honestly which group you're in.

Reviewed by Dr. Kshitij Chaudhary. Last reviewed October 2026

What is cervical disc replacement?

It's an operation that removes a damaged disc from your neck and replaces it with an artificial disc. The new disc is made of metal, or metal and plastic, and is built to move like a natural disc. You may also hear it called an artificial disc or disc arthroplasty. Think of a knee or hip replacement, but for one of the cushions between the bones of your neck.

The surgeon works through a small cut at the front of the neck. This is the same route used for ACDF.

How is it different from fusion (ACDF)?

In ACDF, the damaged disc is removed and the two bones are joined so they heal as one. That level no longer moves. In disc replacement, the bones are not joined, and the level keeps moving.

The idea is that a moving disc may put less extra load on the discs above and below. There is also nothing to wait for in terms of bone healing. Both operations take the pressure off the nerve equally well. The difference is what happens to the movement afterwards.

Why would a disc in the neck need to come out?

The discs are soft cushions between the bones of your neck. When one bulges or wears, it can press on a nerve, causing arm pain, tingling or weakness. Less often it presses on the spinal cord itself.

Read more: Cervical Disc Herniation, Cervical Radiculopathy and Cervical Spondylosis.

Who needs this surgery?

Most people don't. Neck and arm pain from a slipped disc usually improves over 6 to 12 weeks with medicines, physiotherapy, a soft collar and sometimes an injection. Surgery is worth discussing if:

• Your arm pain is still severe after 6 to 12 weeks of proper treatment
• Your MRI shows a disc pressing on a nerve that matches your symptoms
• Your arm or hand is getting weaker

If you've been told you need surgery and want to be sure, you can send us your MRI for a second opinion →

Who is a good candidate for a disc replacement?

It works best when most of these are true:

• You are younger, usually under 50 or so
• The problem is one or two levels
• The disc is soft and bulging, not hardened by years of wear
• Your arm pain is worse than your neck pain
• Your bones are strong and the joints at the back of the neck are healthy
• Your neck is stable and still moves well at that level

Who is not a good candidate?

An artificial disc needs a neck that still moves and bones strong enough to hold it. It's usually not the right choice if:

• There is a lot of arthritis or bone spurs, or the level is already stiff
• The neck is unstable, or has an abnormal curve
• You have thin bones (osteoporosis)
• There is infection, or an allergy to metal
• Several levels are narrowed and the spinal cord is being squeezed over a long stretch
• Your pain is mostly in the neck with no clear nerve problem

In these situations, ACDF or surgery from the back is usually the safer operation. We'll explain why.

How is the operation done?

1. You're under general anaesthesia, so you're asleep throughout.
2. You lie on your back. The surgeon makes a small cut at the front of the neck, usually in a natural skin crease.
3. The windpipe and food pipe are gently moved to one side. No neck muscles are cut.
4. An X-ray confirms the correct level.
5. The damaged disc is removed, along with any bone spurs, until the nerve or spinal cord is free.
6. The artificial disc is sized to fit and fixed into the disc space.
7. The skin is closed with stitches that dissolve. A thin drain may be left for a day.

Will my neck keep moving?

That is the aim. The artificial disc is designed to keep movement at that level, so the rest of the neck doesn't have to work harder. Most people find their neck moves comfortably in daily life. Over time, bone can sometimes grow around the disc and stiffen it. This is called heterotopic ossification. It is usually mild, and often causes no symptoms.

Will it help my neck pain?

Surgery works best for arm pain, numbness and weakness caused by a pinched nerve. If your pain is mostly in the neck and your nerves are fine, disc replacement is not the answer, and we'll tell you so.

How well does it work?

Arm pain often eases within days. Numbness and weakness are slower, because nerves heal slowly. For the right patient, results are as good as fusion for arm pain, and many people are glad to have kept their movement. Artificial discs have been used for many years, but very long-term results are still being studied. We'll go through what is known when we see you.

What are the risks?

Every operation has risks, and we'll go through them with you before you decide. They include:

• Sore throat, hoarse voice or discomfort swallowing. Common in the first days to weeks, and it usually settles.
• Symptoms that don't fully improve, especially if the nerve or cord was pressed for a long time
• Bone growing around the disc, which can reduce movement
• The disc shifting, sinking or wearing. This is uncommon, but further surgery is sometimes needed, often a fusion.
• Infection, bleeding or a small tear in the nerve covering. All are uncommon.

Serious injury to the spinal cord or nerves is rare.

Can the discs above and below still wear out?

Yes, in some people. The neck ages anyway, whatever operation you have. A disc replacement may lower the extra strain on neighbouring levels, but it can't promise they will never wear. If it happens, we start with exercises and injections.

How can I prepare?

• Stop smoking, ideally weeks before surgery
• Keep your blood sugar well controlled if you have diabetes
• Tell us about every medicine you take. Blood thinners, aspirin, fish oil and herbal medicines may need to be stopped beforehand.

What is recovery like?

You usually get up and walk on the day of surgery. Most people stay in hospital for a day or two. Without a bone to heal, many find recovery is quicker than after fusion. You may need a soft or rigid neck collar for a while to support the neck, and we'll tell you how long.

The timeline below is for people who were already walking normally before surgery. If you had weakness or trouble walking, recovery can take longer, and we'll plan it with you.

Call us the same day if you notice fever, a red or leaking wound, new weakness or numbness in your arms or legs, or swelling in the neck. If you have trouble breathing, come to the hospital straight away.

Questions to ask your surgeon

• Which level is the problem, and does my MRI match my symptoms?
• Have I tried enough non-surgical treatment?
• Am I a good candidate for disc replacement, or is fusion safer for me?
• Which artificial disc will you use, and how long has it been in use?
• What happens if it needs to be converted to a fusion later?
• When can I return to work and exercise?

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About Dr. Kshitij Chaudhary

This page was written by Dr. Kshitij Chaudhary, a fellowship-trained spine surgeon at P.D. Hinduja Hospital, Mumbai, trained in complex spine surgery at Harvard Medical School (Beth Israel Deaconess) and the Twin Cities Spine Center, Minneapolis. 🏃🏾About Dr. Chaudhary

This page is for general information. It doesn't replace advice from your own doctor.