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  • Writer's pictureAmanda Sacino, MD, PhD

Cervical Arthroplasty vs. ACDF: Making an Informed Choice for Neck Pain Relief


When it comes to treating neck pain and cervical spine issues, two prominent surgical options have gained widespread attention: cervical arthroplasty and anterior cervical discectomy and fusion (ACDF). These procedures aim to alleviate pain and improve functionality in patients with cervical disc degeneration, herniation, or other related conditions. In this article, we will delve into the key differences between cervical arthroplasty and ACDF, helping you make an informed decision about the best treatment option for your specific needs.

Cervical Arthroplasty: A Dynamic Approach

Cervical arthroplasty, often referred to as artificial disc replacement, is a surgical procedure designed to maintain the natural motion of the cervical spine while addressing disc-related issues. During this procedure, the damaged disc is removed and replaced with an artificial disc, allowing for continued movement between the vertebrae. This preservation of motion can potentially reduce the risk of adjacent segment degeneration, a concern with traditional fusion procedures.

One of the significant benefits of cervical arthroplasty is the potential for quicker recovery and return to normal activities. Patients may experience improved neck mobility and reduced stress on adjacent discs, leading to a lower chance of needing additional surgeries in the future. Additionally, the maintenance of natural motion can result in reduced strain on the neck muscles, potentially minimizing postoperative discomfort.

ACDF: Achieving Stability Through Fusion

Anterior cervical discectomy and fusion (ACDF) is a well-established surgical technique aimed at addressing cervical disc issues by removing the damaged disc and fusing adjacent vertebrae together. This fusion eliminates movement between the affected vertebrae, providing stability and relieving pressure on nerves causing pain. However, it's important to note that while ACDF effectively resolves the pain associated with damaged discs, it does limit the natural range of motion in the fused segment.

ACDF has a proven track record of providing long-term relief to patients with cervical disc problems. The fusion of vertebrae promotes the healing process and reduces the risk of further disc-related issues in the treated area. However, some patients may experience increased stress on adjacent discs due to the restricted movement, potentially leading to degeneration over time.

Comparing the Two Approaches

When deciding between cervical arthroplasty and ACDF, several factors must be considered, including the patient's age, overall health, lifestyle, and the extent of the cervical spine issue (for example, the health of the facet joints at that level). Here's a comparison to help you make an informed choice:

  1. Motion Preservation: Cervical arthroplasty retains natural motion between vertebrae. ACDF fuses vertebrae, providing stability but limiting motion.

  2. Recovery Time: Cervical arthroplasty often offers a quicker recovery and return to normal activities due to the maintained mobility. ACDF might require a longer recovery period due to the fusion process.

  3. Long-Term Impact: Cervical arthroplasty may result in reduced strain on surrounding muscles and less stress on adjacent discs. ACDF provides stability but might lead to increased strain on neighboring discs.

  4. Risk of Adjacent Segment Issues: Cervical arthroplasty may lower the risk of adjacent segment degeneration. ACDF might increase the risk of adjacent segment problems due to limited mobility.


Ultimately, the choice between cervical arthroplasty and ACDF hinges on various factors unique to each patient. While cervical arthroplasty offers the advantage of motion preservation and potentially quicker recovery, ACDF provides reliable stability and long-term pain relief.

Remember, no two patients are the same, and what works best for one might not be the ideal solution for another. By thoroughly understanding the differences between cervical arthroplasty and ACDF, you can make the most informed decision for your journey towards a pain-free and active life.

Dr. Amanda Sacino is fellowship-trained spinal neurosurgeon who completed her training at Johns Hopkins Hospital.


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