Spine Surgery

​An anterior cervical discectomy and cervical disc arthroplasty (CDA, otherwise known as a cervical disc replacement) is a surgical procedure that alleviates spinal cord and nerve root pressure, and replaces an impaired intervertebral disc with an artificial one to ensure movement in the affected part of your neck.

The difference between an anterior cervical discectomy and CDA and an anterior cervical discectomy and fusion (ACDF) is the CDA replaces an affected spinal disc with an artificial one, instead of fusing the spine. Replacing a disc instead of fusing the spine helps to preserve movement.

You may need a CDA if you experience a degenerative disc disease where the cushion-like discs between the vertebral bones wear out and shrink over many years. Because of this, bony spurs (osteophytes) form and disc herniation may also occur.

Disc herniation or prolapse happens when the inner part of the intervertebral discs bulge or rupture through the outer layer. A patient may also need a CDA if they experience a traumatic injury.

The first part of the procedure – the anterior cervical discectomy – is the same as the discectomy that takes place in an ACDF. However, once a neurosurgeon has completed this, they will perform a CDA instead of a fusion. They will reshape the bony surfaces within the space where the artificial disc implant should be positioned to ensure it fits well. Then they will insert the artificial disc into the space and secure it.

There are several implants available from differing manufacturers. A neurosurgeon will discuss these with their patient during their consultation. Once a neurosurgeon completes the operation, they will close the wound with self-dissolving sutures.

Sources

1. Robinson J, Kothari M. Treatment and Prognosis of cervical radiculopathy. UpToDate, Shefner, J.(Ed), UpToDate, Waltham, MA.
2. Fehlings MG, Tetreault LA, Riew KD, Middleton JW, Aarabi B, Arnold PM, et al. A clinical practice guideline for the management of patients with degenerative cervical myelopathy: recommendations for patients with mild, moderate, and severe disease and nonmyelopathic patients with evidence of cord compression. Global spine journal 2017;7(3_suppl):70S-83S.
3. Kuijper B, Tans JTJ, Schimsheimer RJ, Van Der Kallen B, Beelen A, Nollet F, et al. Degenerative cervical radiculopathy: diagnosis and conservative treatment. A review. European Journal of Neurology 2009;16(1):15-20.
4. Gao Y, Liu M, Li T, Huang F, Tang T, Xiang Z. A meta-analysis comparing the results of cervical disc arthroplasty with anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic cervical disc disease. The Journal of bone and joint surgery. American volume 2013;95(6):555.
5. Hu Y, Lv G, Ren S, Johansen D. Mid-to long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease: a systematic review and meta-analysis of eight prospective randomized controlled trials. PLoS One 2016;11(2):e0149312.