Cervical Artificial Disc Replacement
Minimally Invasive Spinal Fusion Surgery in Bergen County, New Jersey.
For decades, the standard surgical treatment for a cervical herniated disc or cervical degenerative disc disease causing arm pain, numbness, or weakness was ACDF — anterior cervical discectomy and fusion. ACDF works well. It relieves nerve compression effectively and has an excellent track record. But it does so by permanently eliminating motion at the treated level, which changes the mechanics of the cervical spine permanently and places additional stress on the discs above and below the fusion site.
Cervical artificial disc replacement was developed as an alternative that achieves the same goal — removing the damaged disc and relieving nerve compression — while preserving the natural motion of the cervical spine at the treated level. Instead of fusing the vertebrae together after disc removal, an artificial implant that mimics the function of the natural disc is placed in the disc space, allowing the spine to continue moving naturally at that segment.
For appropriately selected patients, cervical disc replacement offers several meaningful advantages over fusion. The clinical evidence supporting it has grown substantially since its FDA approval, and multiple long-term studies now confirm that cervical disc replacement produces outcomes equivalent to or better than ACDF for appropriate candidates, with the added benefit of preserved motion and reduced stress on adjacent spinal levels.
Rishi N. Sheth, MD is certified in the ProDisc-C cervical disc replacement system, one of the most extensively studied and clinically validated cervical disc replacement implants available. He is one of the few spine neurosurgeons in Bergen County with this specific certification, giving patients in northern New Jersey access to motion-preserving cervical spine surgery from a surgeon whose training and credentials are among the strongest in the region.
Understanding the Key Difference — and Knowing Which Is Right for You.
The question patients most commonly ask when they have been told they have a cervical herniated disc or cervical degenerative disc disease requiring surgery is whether they need fusion or whether disc replacement is an option. It is one of the most important conversations in cervical spine surgery, and it is one Rishi N. Sheth, MD has with every eligible patient before any surgical recommendation is made.
Both ACDF and cervical disc replacement start the same way. A small incision is made in the front of the neck, the damaged disc is removed, and the nerve root or spinal cord is decompressed. The procedures diverge at the final step. In ACDF, a bone graft or structural implant is placed in the disc space and a titanium plate is fixed to the front of the vertebrae, joining them permanently. In cervical disc replacement, an artificial implant designed to replicate the natural movement of a cervical disc is placed in the disc space without any plate or fusion. The vertebrae remain separate and continue to move normally.
The clinical implications of this distinction are meaningful. A fused cervical level transfers its normal range of motion to adjacent levels, which must compensate for the lost motion above and below the fusion. Over time, this increased demand on adjacent levels can accelerate degeneration there, a phenomenon called adjacent segment disease. Studies suggest that patients who undergo cervical disc replacement have a lower rate of adjacent segment disease requiring reoperation compared to those who undergo ACDF.
Cervical disc replacement is not appropriate for every patient. It requires adequate bone quality, intact stabilizing ligaments, no significant facet joint arthritis at the treated level, and the absence of significant segmental instability. It is also currently FDA approved for one or two disc level replacements. Patients who need more levels treated, or who have anatomical factors that preclude disc replacement, are better served by ACDF. Dr. Sheth reviews every patient's imaging carefully to determine which procedure gives them the best long-term outcome.
Are You a Candidate for Cervical Disc Replacement?
Patient selection is the most important factor in achieving an excellent outcome from cervical disc replacement. Rishi N. Sheth, MD applies specific criteria to determine whether disc replacement or ACDF is the more appropriate choice for each individual patient.
Good candidates for cervical disc replacement generally share the following characteristics. They have symptomatic cervical disc disease at one or two levels causing radiculopathy, which means arm pain, numbness, or weakness from nerve root compression. Conservative treatment including physical therapy and cervical epidural injections has been tried without adequate relief. MRI imaging confirms disc herniation or degenerative disc disease at the symptomatic level without significant facet joint arthritis at that level. Bone quality is sufficient to support the implant. The patient is generally between 18 and 60 years of age and does not have conditions that would compromise implant integrity such as severe osteoporosis or active infection.
Patients who are not ideal candidates for disc replacement include those who need more than two cervical levels treated, those with significant facet joint arthritis at the involved level, patients with segmental instability requiring fusion for stabilization, those with severe osteoporosis, and patients with prior adjacent level fusion. For these patients, ACDF remains an excellent and well-proven treatment that Dr. Sheth also performs routinely.
If you have been told by another surgeon that you need ACDF and want to know whether disc replacement is a viable option for your anatomy, the free MRI review at Spine Care New Jersey provides an opportunity to get that question answered by a ProDisc-C certified surgeon before committing to a fusion.
What Cervical Disc Replacement Involves and What Recovery Looks Like.
The Procedure
Cervical disc replacement is performed under general anesthesia through the same anterior approach used in ACDF. Rishi N. Sheth, MD makes a small horizontal incision in a natural skin crease on one side of the neck, gently moves the structures of the neck to either side, and accesses the front of the cervical spine. The damaged disc is removed completely, along with
any bone spurs compressing the nerve root or spinal cord. The disc space is carefully prepared to the precise dimensions required for the ProDisc-C implant.
The ProDisc-C implant consists of two metal endplates that anchor to the surfaces of the vertebrae above and below the disc space, with an articulating component between them that allows the natural range of motion of the cervical disc to be replicated. Once the implant is positioned and confirmed with intraoperative imaging, the incision is closed. The procedure typically takes between 60 and 90 minutes for a single level.
Recovery
Recovery from cervical disc replacement is similar to ACDF and in some respects slightly faster, since there is no fusion healing process to wait for. Most patients go home the day after surgery following an overnight observation stay. The arm pain, numbness, and tingling from the compressed nerve root typically begins resolving within the first few days after surgery.
Return to light activity and desk work usually occurs within two to three weeks. Driving is typically permitted at two to three weeks once pain medications have been discontinued. Physical therapy begins at four to six weeks and focuses on cervical strengthening and range of motion work. Because disc replacement preserves motion rather than eliminating it, the postoperative physical therapy program differs slightly from ACDF rehabilitation and emphasizes restoring the full range of cervical movement while protecting the implant during the early healing phase.
Return to more demanding physical activities, sports, and heavy labor generally occurs between eight and twelve weeks, once the implant has become well integrated with the surrounding bone.
ProDisc-C Certified. MSK Fellowship Trained. Bergen County Based.
Cervical disc replacement is not a procedure every spine surgeon offers, and among those who do, the depth of training and certification varies considerably. The ProDisc-C system requires specific surgical training and certification before a surgeon can implant it. This credentialing process is designed to ensure that surgeons who perform ProDisc-C disc replacement have demonstrated technical competency with the implant before using it in clinical practice.
Rishi N. Sheth, MD holds ProDisc-C certification, placing him among a select group of surgeons in New Jersey qualified to offer this specific motion-preserving cervical disc replacement system. This certification is not simply administrative — it reflects a demonstrated mastery of the
surgical technique required to seat the implant correctly, achieve appropriate disc space distraction, and verify proper alignment and fixation before the patient leaves the operating room.
Dr. Sheth also brings a depth of cervical spine surgical expertise that goes beyond the disc replacement procedure itself. His fellowship training in spine surgery at the University of Miami and his neurosurgical oncology fellowship at Memorial Sloan Kettering Cancer Center involved extensive work in and around the cervical spinal cord and nerve roots. This background is particularly relevant for patients with cervical disc disease accompanied by significant nerve compression or early myelopathy, where the decompression component of the procedure requires careful microsurgical technique alongside the implant placement.
For patients throughout Bergen County and northern New Jersey who want to explore whether cervical disc replacement is a better option than the ACDF they have been told they need, Spine Care New Jersey offers the rare combination of ProDisc-C certification, neurosurgical fellowship training, and boutique private practice care in one location.
Common Questions About Cervical Disc Replacement at Spine Care New Jersey.
Cervical artificial disc replacement removes a damaged cervical disc and replaces it with an artificial implant that preserves natural neck movement, unlike ACDF which fuses the vertebrae permanently. Both procedures relieve nerve compression equally well in appropriate patients. The key advantage of disc replacement is preserved motion at the treated level, which reduces long-term stress on adjacent discs and lowers the risk of adjacent segment disease requiring future surgery. Rishi N. Sheth, MD is ProDisc-C certified and offers both procedures at Spine Care New Jersey.
The primary benefits of cervical disc replacement over ACDF fusion are preserved natural neck motion at the treated level, reduced stress on adjacent disc levels, lower rates of adjacent segment disease requiring future surgery, and no fusion healing period to wait for. Clinical studies consistently show outcomes equivalent to or better than ACDF for appropriate candidates over long-term follow-up. Disc replacement is not appropriate for every patient — candidacy depends on bone quality, facet joint condition, and the number of levels involved.
Rishi N. Sheth, MD at Spine Care New Jersey in Bergen County is ProDisc-C certified and one of the few spine neurosurgeons in northern New Jersey offering cervical disc replacement as a genuine alternative to ACDF for eligible patients. He is board-certified by the American Board of Neurological Surgery, fellowship-trained at Memorial Sloan Kettering Cancer Center, and personally performs every procedure and consultation. New patients can book directly or submit their MRI for a free expert review at spinecarenj.com.
Cervical disc replacement carries similar risks to ACDF, including infection, bleeding, temporary hoarseness or swallowing difficulty, and rare risk of nerve or vascular injury. Implant-specific risks include the possibility of implant migration or loosening requiring revision surgery, though this is uncommon with properly selected patients and correctly sized implants. Disc replacement is contraindicated in patients with severe osteoporosis, significant facet arthritis, active infection, or spinal instability. Rishi N. Sheth, MD reviews every candidate’s imaging carefully to confirm disc replacement is appropriate before recommending it.
Most patients go home the day after cervical disc replacement surgery. Arm pain relief typically begins within the first few days. Return to desk work occurs within two to three weeks. Physical therapy begins at four to six weeks, focusing on restoring cervical motion and strength. Return to demanding physical activities typically occurs at eight to twelve weeks. Because there is no fusion healing process, cervical disc replacement recovery is slightly faster than ACDF in terms of return to full activity, though the early postoperative period is similar.