Cervical Disc Replacement Surgery in New York City

Dr. Zeeshan Sardar, MD, MSc, F.R.C.S.C
Director Quality & Patient Safety (QPS) – Och Spine Hospital
Medical Director, Spine Unit – Och Spine Hospital
Co-Chief of Spinal Deformity Surgery • NewYork-Presbyterian / Columbia University
Och Spine Hospital • New York, NY

For decades, anterior cervical discectomy and fusion (ACDF) was the only surgical option for patients with cervical disc disease causing neck and arm pain, radiculopathy, or myelopathy. Fusion reliably decompresses the nerve or spinal cord and eliminates motion at the treated level — but eliminating motion has a cost. The levels above and below a fusion must absorb the mechanical stress that the fused level no longer shares, accelerating their degeneration over time.

Cervical disc replacement — also called cervical arthroplasty — offers a motion-preserving alternative. The damaged disc is removed and replaced with an artificial disc implant that allows continued movement at the treated level, decompressing the nerve or cord while preserving the biomechanics of the cervical spine.

Dr. Sardar completed a dedicated fellowship in artificial disc replacement at the Texas Back Institute — one of the pioneering centers for this technology in North America — and has been performing cervical disc replacement as a core part of his practice ever since. He is one of the most experienced cervical arthroplasty surgeons in New York.

WHAT IS CERVICAL DISC REPLACEMENT?

Cervical disc replacement is a surgical procedure in which a degenerated or herniated cervical disc is removed and replaced with an artificial disc implant. Like ACDF, it is performed through a small incision on the front of the neck and involves complete removal of the disc and decompression of the nerve roots or spinal cord. Unlike ACDF, the disc space is not fused — instead, an implant is placed that replicates the disc’s function and allows continued motion at that level.

The procedure is FDA-approved and supported by over two decades of Level 1 clinical trial data demonstrating outcomes that are equivalent to — and in many measures superior to — ACDF for carefully selected patients.

CONDITIONS TREATED

Cervical disc replacement is used to treat symptomatic cervical disc disease that has not responded to conservative management. Conditions that may be treated with cervical arthroplasty include:

Cervical radiculopathy — arm pain, numbness, or weakness caused by compression of a nerve root by a herniated disc or bone spur
Cervical disc herniation — a disc that has ruptured and is pressing on a nerve root or the spinal cord
Cervical myelopathy — spinal cord compression causing hand clumsiness, gait problems, or other myelopathic symptoms; disc replacement is appropriate in selected single- or two-level cases without significant spondylosis or kyphosis
Cervical spondylosis with radiculopathy — degenerative disc and joint disease causing nerve root compression

Not every patient with cervical disc disease is a candidate for disc replacement. The selection criteria are specific, and Dr. Sardar will review your imaging carefully to determine whether arthroplasty or fusion is the more appropriate option for your anatomy and diagnosis.

DISC REPLACEMENT VS. FUSION: WHAT IS THE DIFFERENCE?

Both procedures decompress the affected nerve or spinal cord through the same anterior approach and achieve equivalent rates of neurological recovery. The key difference is what happens to the treated level — and to the adjacent levels — over the long term.

ACDF (Fusion)

Disc removed, space filled with bone graft or cage
Plate and screws lock the level in place
Treated level becomes immobile permanently
Adjacent levels absorb increased stress over time
Risk of adjacent segment disease over years to decades
May require reoperation at adjacent levels in the future
Appropriate for most cervical disc conditions including kyphosis, significant spondylosis, instability

Cervical Disc Replacement

Disc removed, replaced with motion-preserving implant
Treated level retains range of motion
Normal biomechanical load sharing maintained
Reduced stress on adjacent levels
Lower rates of adjacent segment disease in long-term studies
Lower reoperation rates at adjacent levels in clinical trials
Appropriate for suitable candidates without significant kyphosis, instability, or multilevel spondylosis

WHO IS A CANDIDATE?

Cervical disc replacement is appropriate for carefully selected patients. Ideal candidates generally meet the following criteria:

Symptomatic cervical disc disease at one or two levels causing radiculopathy or myelopathy
Failure of at least 6 weeks of appropriate conservative treatment (physical therapy, medications, injections) — except in cases of progressive neurological deficit or severe myelopathy
Preserved or correctable cervical lordosis — disc replacement is not appropriate in patients with cervical kyphosis at the affected level
No significant facet joint arthritis at the affected level
No instability or listhesis at the affected level
Skeletally mature (growth complete)

Patients who are not candidates for disc replacement — due to significant kyphosis, multilevel spondylosis, instability, OPLL, or other factors — are offered ACDF, which remains an excellent procedure with a long track record of success. Dr. Sardar will give you a clear and honest recommendation based on your specific imaging and clinical presentation.

THE EVIDENCE: WHAT THE RESEARCH SHOWS

Cervical disc replacement is one of the most extensively studied procedures in spine surgery. Multiple prospective randomized controlled trials — the highest level of clinical evidence — have compared cervical arthroplasty to ACDF with follow-up extending to 10 years and beyond. Key findings include:

Equivalent neurological outcomes — both procedures achieve similar rates of arm pain relief, neurological recovery, and patient satisfaction
Lower adjacent segment reoperation rates — multiple trials have demonstrated statistically significant reductions in the rate of reoperation at adjacent levels in patients treated with disc replacement versus fusion at 5–10 year follow-up
Preserved range of motion — the treated level retains functional motion on long-term follow-up imaging in the majority of patients
No increased complication rate — the safety profile of cervical arthroplasty is comparable to ACDF in randomized trial data

For younger, active patients who want to preserve as much cervical function as possible and minimize the risk of future surgeries, disc replacement offers compelling long-term advantages over fusion when candidacy criteria are met.

THE PROCEDURE

Cervical disc replacement is performed under general anesthesia through a small transverse incision on the front of the neck — the same approach used for ACDF. The steps are as follows:

The disc is completely removed and any bone spurs compressing the nerve or cord are carefully cleared under magnification
The disc space is prepared to precise dimensions to accommodate the implant
The artificial disc is inserted and seated within the disc space; most modern implants are self-securing and require no additional screws or plates
Intraoperative imaging confirms correct implant position and sizing
The incision is closed in layers; the scar is typically small and heals well within the natural skin crease of the neck

Intraoperative neuromonitoring is used throughout the procedure to provide continuous feedback on nerve root and spinal cord function.

WHAT TO EXPECT: RECOVERY

Recovery from cervical disc replacement is generally faster than from ACDF because there is no fusion to protect during healing. Most patients notice significant improvement in arm pain within days to weeks of surgery.

Hospital stay: Most patients go home the same day or after one overnight stay.
Return to light activity and desk work: Typically 1–2 weeks.
Return to physical work or exercise: Usually 4–6 weeks, guided by Dr. Sardar’s post-operative protocol.
Driving: Typically cleared within 2–4 weeks once off narcotic pain medication and comfortable with neck rotation.
Neck collar: A soft collar may be recommended for comfort in the first week; prolonged rigid immobilization is generally not required.
Motion recovery: Range of motion at the treated level is preserved from the outset and does not require waiting for fusion to occur.

FREQUENTLY ASKED QUESTIONS

How do I know if I need disc replacement or fusion?

The decision depends on your specific diagnosis, the number of levels involved, your cervical alignment, and the nature of your compression. Dr. Sardar will review your MRI, CT, and X-rays in detail and recommend the procedure that is most appropriate for your anatomy. If you are a candidate for disc replacement, he will discuss it; if you are not, he will explain why and what the better option is.

Can cervical disc replacement be done at two levels?

Yes. Two-level cervical disc replacement is FDA-approved and supported by clinical trial data. The biomechanical benefit of preserving motion at two levels is in fact greater than at a single level. Two-level arthroplasty is appropriate for carefully selected patients with symptomatic disease at two contiguous cervical levels meeting candidacy criteria.

Will the artificial disc wear out?

Modern cervical disc implants are engineered for long-term durability. The bearing surfaces are typically made of cobalt-chrome alloy, titanium, or ultra-high molecular weight polyethylene — materials with well-established longevity in joint replacement surgery. Long-term clinical trial data at 10 years and beyond have not demonstrated significant wear-related failure. The implants are designed to last decades.

Can I have an MRI after cervical disc replacement?

Yes. All modern FDA-approved cervical disc implants are MRI-compatible. There may be some artifact on imaging near the implant, but MRI of the cervical spine and the rest of the body can be safely performed after surgery.

What if I already had a fusion — can I still have disc replacement at an adjacent level?

In carefully selected patients, yes. Disc replacement at a level adjacent to a prior fusion — sometimes called a “hybrid” construct — is a well-described technique aimed at reducing the risk of further adjacent segment disease. Whether this is appropriate depends on the specific anatomy, alignment, and the nature of your prior surgery. Dr. Sardar will evaluate your situation individually.

WHY CHOOSE DR. SARDAR FOR CERVICAL DISC REPLACEMENT

Dr. Sardar completed a dedicated fellowship in artificial disc replacement at the Texas Back Institute — one of the centers at the forefront of developing and refining this technology in North America. This training, combined with his additional fellowships in orthopedic and neurosurgical spine surgery and complex spinal deformity, gives him a uniquely comprehensive foundation for cervical spine surgery.

He has been performing cervical disc replacement as a core component of his practice since fellowship and is one of the most experienced cervical arthroplasty surgeons in New York. He is equally expert in ACDF and will always recommend the procedure that best serves each individual patient — never one over the other based on preference.

He operates at the Och Spine Hospital at NewYork-Presbyterian, where intraoperative neuromonitoring and advanced imaging are available as standard for all cervical procedures.

Patients travel from across the United States and internationally to see Dr. Sardar for cervical disc replacement. Telemedicine consultations are available for patients in NY, NJ, CT, FL, PA, MO, CA, and TX.

This page is for educational purposes only and does not constitute individualized medical advice. Please consult a qualified spine specialist to discuss your specific condition and treatment options.