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Artificial cervical disc surgery, also known as cervical disc arthroplasty or total disc replacement, is a motion-preserving procedure that removes a damaged cervical disc and replaces it with a mechanical device designed to maintain natural neck movement. Unlike traditional fusion surgery that eliminates motion at the treated level, artificial disc replacement allows the spine to continue moving normally while relieving nerve compression and pain. This approach may reduce stress on adjacent spinal levels and potentially decrease the risk of developing adjacent segment degeneration over time.
Dr. Thomas M. Wascher performs cervical disc arthroplasty using the Mobi-C artificial disc for carefully selected patients who meet strict criteria for this advanced procedure. The Mobi-C device consists of two metal plates connected by a polyethylene core that functions like a ball-and-socket joint, providing controlled motion that mimics natural disc mechanics. With 33+ years of experience performing 4,500+ cervical spine surgeries, Dr. Wascher has achieved excellent results with cervical disc arthroplasty in appropriately selected candidates.
The procedure is performed through a small anterior neck incision similar to traditional discectomy, but instead of fusing the vertebrae, the artificial disc preserves motion while providing stability and pain relief. Most patients undergo the procedure on an outpatient basis and experience minimal postoperative restrictions compared to fusion surgery.
A 37-year-old woman presented with three weeks of excruciating neck and right shoulder pain radiating down her arm. She developed progressive weakness in her deltoid muscle and loss of sensation despite treatment with oral steroids and physical therapy. MRI revealed a large right C4-C5 disc herniation compressing the nerve root.
A cervical epidural cortisone injection provided only 20% improvement. Her symptoms continued to worsen with ongoing weakness, making her a surgical candidate. After thorough evaluation, she was deemed an ideal candidate for Mobi-C artificial cervical disc replacement.
Dr. Wascher performed the artificial disc procedure in less than one hour. Her pain was eliminated upon waking from anesthesia. With continued physical therapy, her deltoid strength returned fully. She was able to return to work and resume normal activities with full neck motion preserved.
Cervical disc arthroplasty is recommended only for carefully selected patients who meet specific criteria. Not everyone with cervical disc disease is a candidate for artificial disc replacement. Dr. Wascher evaluates each patient thoroughly to determine if disc arthroplasty or traditional fusion is the most appropriate treatment.
Ideal candidates for artificial cervical disc surgery include:
Single-Level or Two-Level Disc Disease: Patients with herniated discs or degenerative disc disease causing nerve root or spinal cord compression at one or two adjacent cervical levels. Three-level or multilevel disease is generally better treated with fusion.
Normal Bone Quality: Patients must have healthy bone without osteoporosis, osteopenia, or metabolic bone disease. The artificial disc requires strong bone to achieve secure fixation. Bone density testing may be performed to confirm adequate bone quality.
Intact Posterior Spine Elements: The facet joints, lamina, and ligaments at the back of the spine must be relatively normal without significant arthritis, fractures, or prior surgery. Artificial discs rely on these posterior structures for stability.
Stable Spinal Alignment: Patients must have normal cervical alignment without significant kyphosis, scoliosis, or instability. Artificial discs cannot correct major deformities or provide stability in unstable spines.
Failed Conservative Treatment: As with fusion surgery, disc arthroplasty is reserved for patients who have failed conservative treatment including physical therapy, medications, and injections over a minimum period.
Age Considerations: Younger patients who want to maintain neck motion and potentially reduce long-term adjacent segment disease risk are often good candidates. Older patients with widespread degenerative changes may be better served with fusion.
Artificial cervical disc surgery is performed through an anterior approach identical to traditional anterior cervical discectomy. Dr. Wascher makes a small horizontal incision at the front of the neck, typically placed in a natural skin crease for minimal visible scarring. He accesses the cervical spine by gently moving the trachea, esophagus, and carotid artery aside without cutting neck muscles.
Using microscopic magnification, Dr. Wascher removes the entire damaged disc including any herniated fragments and bone spurs that compress the nerve roots or spinal cord. The cartilage endplates on the top and bottom of the disc space are carefully prepared to create flat, parallel surfaces for artificial disc placement.
The Mobi-C artificial disc is sized to match the patient's anatomy and inserted into the prepared disc space. Proper positioning is confirmed with intraoperative X-ray imaging to ensure the device sits centered between the vertebrae with appropriate alignment. The teeth and porous coating on the metal endplates grip the vertebral bone immediately, providing initial stability without requiring screws or cement.
The entire procedure is performed under general anesthesia with intraoperative neuromonitoring to continuously assess spinal cord and nerve root function. Most single-level and two-level disc arthroplasty procedures are performed on an outpatient basis with minimal postoperative discomfort.
Most patients experience significant relief of arm pain immediately after surgery as nerve compression is eliminated. Neck pain may take longer to resolve as soft tissues heal. Unlike fusion surgery, cervical disc arthroplasty does not typically require postoperative bracing with a cervical collar, allowing earlier return to normal activities.
Physical therapy focuses on restoring neck strength and range of motion while the artificial disc integrates with the surrounding bone. The device begins functioning immediately, allowing controlled motion throughout the healing process. Return to work and daily activities varies based on the patient's occupation and individual healing.
Long-term outcomes with the Mobi-C artificial disc have shown excellent results for appropriately selected patients. The device maintains motion at the treated level while providing pain relief and neurological improvement comparable to fusion surgery. Patient satisfaction rates are high among those who meet the strict candidacy criteria.
Follow-up imaging confirms proper device position, bone integration, and preservation of motion. Patients maintain functional neck motion without the loss of motion that occurs with fusion surgery. The theoretical benefit of reducing adjacent segment disease requires long-term follow-up studies, but early results are encouraging.
Vanessa had years of neck pain leaving her unable to even do her daily work. But with Dr. Wascher’s quick and timely intervention that included multiple viewings of MRIs, muscle and nerve tests, followed by a 3-Level Anterior Cervical Fusion, she is now happy without any neck issues. “I can happily say that by following the recommendations of Dr. Wascher, I am now pain-free,” says Vanessa as she talks about how great Dr. Wascher and his team were to work with.
When Nanette experienced deep pain in her shoulder, she got tests performed, only to discover that she, in fact, had issues with her neck instead. After a few MRIs and scans, she contacted Dr. Wascher, who told her that she has bone spurs going into the spinal cord. Within a span of 3 weeks, she was able to go through surgery and get on the road to recovery. “I cannot say enough about Dr. Wascher’s expertise and empathy”, says Nanette as she joins an ever-growing community of people who, through Dr. Wascher and his team, have found happiness again.
Dr. Thomas M. Wascher is one of the few cervical spine specialists in the country who focuses exclusively on the cervical spine, bringing unmatched expertise to complex motion-preservation procedures. With 4,500+ cervical spine surgeries performed over 33+ years, he has the experience to carefully select appropriate candidates for artificial disc surgery and achieve excellent outcomes.
Dr. Wascher's comprehensive approach includes thorough evaluation of each patient's specific anatomy, bone quality, and degenerative changes to determine if disc arthroplasty or fusion is the most appropriate treatment. Not every patient with cervical disc disease is a candidate for artificial disc replacement, and Dr. Wascher provides honest guidance about which procedure offers the best long-term results for each individual.
His microscopic surgical technique minimizes tissue disruption and promotes faster recovery. Combined with advanced intraoperative imaging and neuromonitoring, Dr. Wascher's approach maximizes safety and precision during artificial disc implantation.
Both procedures remove the damaged disc and decompress nerves through an anterior approach. Fusion permanently connects the adjacent vertebrae with a bone graft or cage, eliminating all motion at that level. Artificial disc replacement inserts a mechanical device that preserves controlled motion while providing decompression. The primary advantage of disc arthroplasty is motion preservation, which may reduce stress on adjacent levels and potentially decrease long-term adjacent segment disease risk.
Good candidates are generally younger patients with single-level or two-level disc disease, normal bone quality, intact posterior spine elements, stable alignment, and no contraindications. Patients with osteoporosis, severe arthritis, instability, or multilevel disease are typically better candidates for fusion. Dr. Wascher performs a comprehensive evaluation, including imaging studies and bone quality assessment, to determine candidacy.