Cervical disc replacement, by a high-volume spine surgeon.

Prices vary by hospital, by surgeon, by prosthesis platform and by length of stay. NHS availability for cervical arthroplasty is patchy and highly consultant-dependent, so most patients seeking cTDR come through the private route. We come back with a firm quote within one working day.

1. 01

   Before

   You send us your MRI and symptoms

   A short, confidential form. Your MRI report or images, symptom pattern (arm pain, weakness, myelopathic signs) and any prior injections or physio.

2. 02

   Before

   We come back with a recommendation

   Within one working day: whether cTDR fits, or whether ACDF, hybrid or non-operative care is the better call. Indicative price. An honest read either way.

3. 03

   Before

   We arrange consultation and surgery

   Usually within two to three weeks. Pre-assessment, anaesthetic review, and prosthesis selection (Mobi-C, Prestige LP, M6-C, ProDisc-C, Bryan or Baguera-C).

4. 04

   On the day

   Arrival at the hospital

   Admission on the morning of surgery, consent and marking. General anaesthesia, supine positioning with the neck gently extended on a support.

5. 05

   On the day

   The operation itself

   60 to 90 minutes. Anterior Smith-Robinson approach through a 3 to 4 cm transverse crease, discectomy, PLL release, endplate preparation and prosthesis implantation under fluoroscopy.

6. 06

   On the day

   Overnight or same-day discharge

   Selected single-level cases go home the same day. Two-level, myelopathic or older patients stay one night for observation and mobilisation.

7. 07

   After

   Rehab, driving, sport

   Soft collar 1 to 2 weeks for comfort, driving at 2 to 3 weeks, desk work at 2 weeks, non-contact sport at 6 weeks, contact and impact sport at 12 weeks.

• Single-level cervical radiculopathy

  Arm pain in a clear dermatomal pattern from a soft disc herniation or foraminal osteophyte at one level, C3 to C7, unresolved after conservative care.

• Two-level cervical radiculopathy

  Adjacent-level disease with matching arm symptoms, where preserving motion at both segments is preferable to a two-level fusion.

• Mild to moderate cervical myelopathy

  Cord compression from a soft disc with early hand clumsiness or gait change, where anterior decompression and motion preservation are appropriate.

• Younger, active patient (30 to 65)

  Age 30 to 65, physically active, with healthy adjacent segments and good bone quality, where motion preservation matters over decades.

• Failed non-operative care

  Six to twelve weeks of physiotherapy, gabapentinoids or a targeted cervical root injection, with persistent arm pain or progressive neurology.

• Facet arthrosis: cTDR is not for you

  Significant posterior facet joint arthrosis on MRI or CT loads the prosthesis abnormally and drives heterotopic ossification. ACDF is the safer call.

• Ankylosing spondylitis, DISH, instability

  A stiff or fused spine, or dynamic instability on flexion-extension films, contraindicates cTDR. Osteoporosis and prior fusion do too.

• Red flag: progressive myelopathy

  Rapidly progressive weakness, bowel or bladder change, or severe cord compression needs urgent NHS assessment, not a private booking.

• General anaesthesia and airway

  Full general anaesthesia with careful head and neck positioning. An anaesthetic assessment covers airway, cardiac and comorbidity risk before you consent.

• Dysphagia (5 to 15%)

  Transient difficulty swallowing after the anterior approach is common but usually settles within days to weeks. Persistent dysphagia beyond three months is uncommon.

• Recurrent laryngeal nerve palsy (1 to 3%)

  Hoarseness from stretch or pressure on the nerve. Usually transient and resolves within weeks to months; permanent palsy is uncommon.

• C5 palsy (2 to 5%)

  Deltoid and biceps weakness in the first weeks after decompression at C4-C5 or C5-C6. Most cases recover fully over three to twelve months.

• Heterotopic ossification (20 to 40%)

  Bone forms around the prosthesis on later X-rays in a substantial minority. Often asymptomatic and does not always restrict motion, but is discussed before you consent.

• Subsidence and migration

  The prosthesis can settle into the endplate or shift a fraction of a millimetre. Modern fixation makes clinically significant subsidence uncommon.

• Revision surgery (1 to 3% at 5 years)

  Revision for persistent symptoms, prosthesis failure, or progressive degeneration is uncommon but real. IDE trials suggest lower adjacent-segment reoperation than ACDF at ten years for some devices.

• Soft collar and driving

  A soft collar for comfort for one to two weeks. Driving at two to three weeks once neck rotation is comfortable and you are off strong analgesia. Impact sport at twelve weeks.

• Red flags after discharge

  Rapidly worsening arm or leg weakness, new bowel or bladder change, severe swelling in the neck, difficulty breathing or a fever above 38C. Call the unit or go to A&E the same day.