What it is
The worn or herniated disc is removed through a small incision at the front of the neck, pressure is taken off the nerve root or spinal cord, and an artificial disc is placed into the space. Unlike a fusion, the implant is designed to move, so the treated level keeps most of its normal motion.
Who it is for
Best suited to people with nerve or cord compression from a disc at one or two levels, with reasonable alignment, good bone quality and facet joints that are not badly worn. It is not the right operation where there is significant instability, deformity, advanced facet arthritis or osteoporosis — in those situations a fusion does the job better.
How it works
Through a small transverse incision, the structures of the neck are moved aside rather than cut. The disc is removed entirely and any bone spurs or fragments compressing the nerve or cord are taken away. The implant is sized and placed under X-ray guidance. The incision usually heals to a fine line within a natural skin crease.
Recovery
Many patients go home the same day or after one night. Most people are off strong pain medication within a week and back to desk work within one to two weeks. A collar is generally not required, and gentle movement is encouraged early, which is one of the practical advantages over a fusion.
Risks and alternatives
As with any neck operation: bleeding, infection, difficulty swallowing for a period, voice change, and — uncommonly — injury to the nerves or cord. Specific to the implant: it can settle, move or, over long periods, wear. The main alternatives are an ACDF, a posterior decompression, or continued non-operative care, and Dr. Long will set out why one fits your anatomy better than another rather than presenting a preference.