Artificial disc replacement, also known as arthroplasty, is the replacement of a damaged spinal disc with an artificial (manufactured) disc.

An artificial disc is designed to support the vertebrae while still allowing backward and forward bending, side-to-side bending, and turning. Many artificial discs have been approved for use by the Food and Drug Administration (FDA). In general, they are composed of two endplates that move and slide on a central core. They are composed of metals like titanium or cobalt and sometimes a plastic such as polyethylene or polyurethane.

The best candidates for arthroplasty are younger patients who have a single disc herniation and normal spinal motion at the level of the disc. In some patients, the replacement of more than one disc is possible. Older patients who have significant arthritis, bone spurs and limited mobility at the disc level are generally not good candidates for arthroplasty.

This procedure is performed under general anesthesia. The surgeon makes an incision in the front of the neck and carefully exposes the front of the spine. X-ray imaging helps the surgeon verify the correct level of surgery.

Using an operating microscope, the surgeon removes the herniated or damaged disc, a procedure called a discectomy. An artificial disc of the appropriate size is then inserted into the disc space. Another X-ray confirms the positions of the plates. Then the surgeon closes the incision with sutures. The surgery typically lasts one to two hours.

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