Cervical disc replacement (cervical arthroplasty) is neck surgery that removes a damaged disc pressing on a nerve root or the spinal cord and replaces it with a moving artificial disc. It is done through a small cut at the front of the neck. Unlike a fusion, the level keeps moving. Most people go home the same day or the next and return to desk work within 2 to 6 weeks. Preparing well means planning for a sore throat, light lifting and a few weeks of help.
It is usually offered when arm pain, numbness or weakness from a pinched nerve has not settled with time and other treatment, most often at one or two levels. Not everyone is suited to it. Marked arthritis in the facet joints at the back of the neck, thinning bones (osteoporosis) or instability at that level often point surgeons toward a fusion instead. Your surgeon’s protocol comes first. If their instructions differ from anything here, use theirs.
Key takeaways
- What it does: removes a damaged disc and fits a moving artificial disc, so that level keeps its motion.
- Who it suits: usually people with nerve or cord pressure at one or two levels without marked joint arthritis or unstable bones.
- Hospital stay: most people go home the same day or after one night.
- Early effects: a sore throat, hoarse voice and tight swallowing are common for the first weeks.
- Return: desk work often within 2 to 6 weeks; most usual activities by about 3 months.
What the operation does
- The approach: a cut of about 1 to 2 inches at the front of the neck, often in a skin crease. The windpipe, food pipe and the nerve to the voice box are moved gently aside.
- Removing the disc: the damaged disc and any bone spurs pressing on the nerve or cord are taken out.
- The artificial disc: two metal plates, fixed to the bones above and below, with a gliding surface between them, often plastic or metal. The design lets the level bend and turn.
- The aim: to take pressure off the nerve or spinal cord and keep movement at that level. Whether it protects the levels next door over many years is still being studied.
What to set up at home
- Help: an adult with you for the first night or two, and help with shopping, laundry and heavier jobs for 2 to 4 weeks.
- Food: soft, moist meals and cool drinks for the first week or two. Soup, eggs, yogurt and soft fish are easy to swallow.
- Workspace: screen top at or just below eye level, keyboard close, and a timer for a break every 20 to 30 minutes for your return to work.
- Kitchen: everyday items between waist and shoulder height. Light pots and a half-filled kettle.
- Sleeping: a pillow that keeps your neck level on your back and side.
- Driving: arrange rides for about 2 to 4 weeks, and for your wound check.
What to practice before surgery
- Getting out of bed: roll to your side, lower your legs, push up with your arms. It spares the neck in the first days.
- Swallowing: small sips and small mouthfuls, chin slightly tucked. Practice the habit now so it is easy when the throat is sore.
- Walking: 10 to 20 minutes a day, if your symptoms allow. It is the main exercise for the first weeks of recovery after disc replacement.
- Gentle movement: any neck, shoulder blade or upper back exercises your surgeon or PT allows. Learning them before surgery makes them easier to restart.
The new disc keeps the level moving. Your job in the first weeks is to protect the wound and the throat while the rest of the neck catches up.
Questions to ask your surgeon
- Why a disc replacement rather than a fusion for me?
- How many levels, and which ones?
- Which of my symptoms do you expect to improve, and how quickly?
- How much may I move my neck in the first two weeks?
- Will you prescribe anti-inflammatory medicine after surgery, and for how long?
- What can I lift, and when can I drive and return to work?
- Will I need a collar?
- Does the artificial disc affect future MRI scans or airport security?
The first 48 hours
You wake with a small dressing at the front of the neck and a sore throat. Nurses check your breathing, swallowing, voice and the strength in your arms and legs often in the first hours. Arm pain is often eased by the time you wake. An ache in the neck and between the shoulder blades is common.
You will be walking the same day or the next. Take pain relief on schedule at first, and keep to sips and soft food. Use ice on the front of the neck if your team suggests it.
Call your surgeon or emergency number if
- Trouble breathing: difficult or noisy breathing. Call your local emergency number.
- Neck swelling: swelling at the front of the neck that grows quickly. Call your local emergency number.
- Swallowing: you cannot swallow sips of water, or swallowing gets worse each day.
- Voice changes: your voice weakens or goes, instead of slowly improving.
- New weakness: new or worsening weakness in an arm or a leg, unsteady walking, or loss of bladder or bowel control.
- Wound or fever: redness spreading from the wound, discharge, a bad smell, or a fever of 100.4°F (38°C) or higher.
- Calf or chest: one calf swollen and painful, or sudden breathlessness or chest pain.
More on this area: surgery recovery guides.
Plan for the throat and the first two weeks, and know why your surgeon chose a disc replacement for you.
Written by Louise Yow, Neck & Shoulder Physio.