Artificial Cervical Disc Replacement: Preserving Neck Mobility and Preventing Adjacent Segment Disease

Chronic neck pain that radiates down into the shoulder, arm, or hand—a condition known as cervical radiculopathy—can make simple daily movements exhausting. When an intervertebral disc in the neck herniates or breaks down due to degenerative disc disease, it compresses nearby spinal nerves or the spinal cord itself.

For decades, the standard surgical gold standard for treating severe cervical disc disease was Anterior Cervical Discectomy and Fusion (ACDF). While ACDF effectively relieves nerve compression by removing the damaged disc and fusing the adjacent neck bones together, it permanently eliminates natural motion at that segment.

At the University of Miami Health System and Jackson Memorial Hospital, orthopedic spine specialist Dr. Evan Trapana utilizes Artificial Cervical Disc Replacement (Cervical Arthroplasty) as an advanced, motion-preserving alternative. By replacing the damaged disc with a modern medical device designed to mimic natural neck biomechanics, Dr. Trapana relieves nerve pain while maintaining full neck mobility and protecting neighboring spinal levels.

The Fundamental Difference: Fusion vs. Disc Replacement

To choose the right surgical treatment for your neck, it helps to understand how each option alters your spinal mechanics:

Anterior Cervical Discectomy and Fusion (ACDF)

During ACDF, the surgeon removes the herniated or degenerate disc, places a bone graft or synthetic spacer in the empty space, and secures a metal plate with screws across the adjacent vertebrae. Over time, the two bones grow together into a single, solid piece of bone.

• The Drawback: Fusing the segment permanently stops motion at that level. The biomechanical stress that the fused level used to absorb is transferred directly to the healthy discs above and below it.

Artificial Cervical Disc Replacement (Cervical Arthroplasty)

During disc replacement, Dr. Trapana removes the damaged disc material to decompress the compressed spinal nerves, just as in ACDF. However, instead of placing a rigid bone graft and plate, he inserts a high-tech artificial cervical disc composed of medical-grade metals and durable polymers.

• The Advantage: The motion-preserving implant replicates the original movement of a healthy natural disc—allowing flexion, extension, lateral bending, and rotation.

[ACDF (Fusion)] ──> Decompresses Nerves ──> Fuses Vertebrae ──> Permanent Loss of Motion

VS.

[Disc Replacement (Cervical Arthroplasty)] ──> Decompresses Nerves ──> Inserts Prosthesis ──> Full Motion Preserved

Preventing Adjacent Segment Disease (ASD)

The primary long-term biological benefit of artificial disc replacement is reducing the risk of Adjacent Segment Disease (ASD).

When a segment of the neck is fused, the adjacent disc levels are forced to hyper-rotate and absorb additional mechanical strain every time you look up, down, or turn your head. Clinical studies show that within 10 years of a cervical fusion, up to 25% of patients develop symptomatic disc degeneration at neighboring levels, often requiring secondary surgeries.

By maintaining normal range of motion and preserving natural shock-absorption kinetics, artificial disc replacement prevents this hyper-mobility stress, protecting healthy neighboring discs and lowering the likelihood of future neck surgeries.

Comparing ACDF and Cervical Disc Replacement

Who is a Candidate for Cervical Disc Replacement?

Artificial disc replacement is a highly effective procedure for eligible patients, but candidate selection is essential. Ideal candidates generally include:

• Patients diagnosed with cervical radiculopathy or myelopathy caused by a single-level or two-level herniated disc or bone spur.
• Individuals who have failed conservative therapies (physical therapy, medications, epidural steroid injections) for at least 6 weeks.
• Patients with minimal or no facet joint arthritis and preserved baseline bone density.

Note: Patients with severe multi-level osteoarthritis, spinal instability, or osteoporosis may still be better served by traditional fusion techniques.

Conclusion

Relieving severe arm pain and neck stiffness does not require sacrificing your natural flexibility. Through advanced Artificial Cervical Disc Replacement, Dr. Evan Trapana provides patients across Miami and South Florida with an innovative, motion-preserving pathway toward lasting relief.

• Practicing Specialist: Dr. Evan Trapana, MD (Orthopedic Spine Surgeon)
• Academic Appointment: Assistant Professor of Orthopedics, University of Miami Miller School of Medicine
• Primary Practice Location: 1400 NW 12th Avenue, Suite 2, Miami, FL 33136
• Clinical Affiliations: University of Miami Health System & Jackson Memorial Hospital
• Appointments & Consultations: 305-243-3000