Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
Out-of-state? Free MRI review + telehealth consult before you travel4.9 ★ · 619 Google reviewsBoard-certified — American Board of Orthopaedic SurgeryMinimally invasive, same-day spine surgery in Beverly HillsCall (424) 217-7463
After BESS, this is the procedure Dr. Melamed most wants patients to know about. Instead of locking a worn segment in place, the failing disc is replaced with an implant that keeps it moving.
What Is Artificial Disc Replacement and How Does It Work?
Artificial disc replacement is a motion-preserving alternative to fusion. When a single disc has worn out and is driving pain, the traditional answer has often been to fuse the two vertebrae together. That can settle the pain, but it stops motion at that level for good. Disc replacement takes a different path: the damaged disc is removed and a mobile implant goes into its space, restoring height and letting the segment bend and rotate much as it did before.
Keeping that motion matters for more than flexibility. When one level is fused, the levels above and below take on extra load and can wear faster over time. Preserving movement is meant to protect those neighboring segments, which matters most for younger, active patients who want to stay that way for decades.
This is one of the most important parts of Dr. Melamed's practice. A lot of patients reach him after being told fusion is their only option. He looks hard at whether a disc replacement can do the job instead, and for the right anatomy, a fusion recommendation becomes a disc replacement. He has performed artificial disc replacement for years and was named in Becker's Spine Review's 2014 list of spine surgeons performing the procedure. It is available for both the neck and the lower back, at the Beverly Hills office in the greater Los Angeles area.
Spine-related back or neck pain is extremely common, with as many as 80% of American adults experiencing back pain at some point during their lives and roughly 200,000 patients undergoing surgery for cervical (neck) degenerative disc disease each year alone. When symptoms are caused by a damaged spinal disc and conservative treatments fail to provide adequate relief, artificial disc replacement (ADR) provides an advanced surgical option designed to relieve pain while preserving natural spinal movement.
Healthy spinal discs sit between the bones of the spine and serve to provide cushioning, stability, and flexibility. Over time, injury or age-related degeneration can cause a disc to lose height, dry out, or press on nearby nerves, which can lead to pain, weakness, or reduced mobility.
Disc replacement for the lumbar spine was first approved by the United States (U.S.) Food and Drug Administration (FDA) in 2005, followed by cervical disc replacement in 2007. Since then, extensive clinical research and long-term studies have demonstrated consistent safety, durability, and effectiveness for appropriately selected patients.
The best candidates have pain coming from a worn or herniated disc without significant instability, arthritis of the small joints, or advanced deformity. In other words, the disc is the problem, and the rest of the segment is still healthy enough to move safely. Dr. Melamed reviews your imaging carefully, because the same MRI that makes one person an ideal candidate for disc replacement can point another toward fusion. Confirming the right fit is the most important step.
ADR surgery isn’t appropriate for every spinal condition or every patient. Your doctor can provide the most personalized guidance and recommendations for you. However, the best candidates are typically patients with persistent neck or back pain traced to one or two spinal discs that have not improved with conservative care options, such as physical therapy, medications, or spinal injections. In general, good candidates for ADR surgery are people who:
Have confirmed disc damage in imaging studies, such as MRI or CT scans
Experience ongoing pain, numbness, or weakness related to nerve irritation
Have relatively healthy surrounding joints and bones
Do not have significant spinal instability or severe deformity
Are in good overall health for surgery
The Artificial Disc Replacement Procedure: What To Expect
For a cervical (neck) or lumbar (lower back) disc, Dr. Melamed removes the damaged disc and relieves any pressure on the nerves, then places a precisely sized implant into the empty disc space. The device is engineered to reproduce natural motion while restoring the proper spacing between the vertebrae.
Because the segment is meant to keep moving rather than knit solid, there is no waiting for bone to fuse. The implant does its job immediately, and the focus shifts to comfortable, gradual return to activity.
An artificial disc replacement procedure is usually performed in a hospital or specialized center under general anesthesia, which means you’ll be asleep the whole time and feel no pain. The exact approach depends on whether the affected disc is in the neck (cervical spine), middle back (thoracic spine), or lower back (lumbar spine), but the overall steps are similar.
In total, the ADR procedure takes about one to two hours. First, the surgeon makes small, carefully placed cuts to access the affected region of the spine. They will gently move aside muscles and soft tissues before removing the damaged disc along with any material pressing on nerves or the spinal cord. The surrounding bone is prepared to ensure there is room for the implant, and, finally, the artificial disc is placed in the correct position.
For cervical procedures, the spine may be accessed through the front of the neck, which allows direct access to the disc with minimal disruption to surrounding structures.
Like with any operation, ADR carries some risk. However, serious complications are uncommon when performed by an experienced spine surgeon. Possible risks and complications may include:
Infection at the surgical site or around the implant
Bleeding or blood clots in the legs after surgery
Injury to nearby nerves or surrounding structures
Movement, loosening, or wear of the artificial disc over time
Implant failure, fracture, or improper positioning
Stiffness or persistent pain after surgery
Watch Dr. Melamed explain
Artificial Disc Replacement vs. Spine Fusion · Dr. Hooman Melamed on YouTube
Recovery Timeline and Returning to Normal Activities
Most patients notice that recovery feels different from a fusion — there is no fusion to protect while it heals. Many go home the same day or after a short stay, resume walking and light activity quickly, and build back toward full function over the following weeks under Dr. Melamed's guidance, with a narcotic-sparing plan throughout.
You’ll be monitored throughout and after the procedure, as you recover from anesthesia. Early movement is encouraged to promote circulation and reduce stiffness.
Light daily activities can be resumed within days, while desk work or more rigorous activities may be possible within a few weeks. Physical therapy is sometimes recommended to rebuild strength and flexibility.
Why Keep the Segment Moving Instead of Fusing It?
✓Preserves natural motion instead of locking the segment
✓Helps protect the discs above and below from extra strain
✓No waiting for bone to fuse
✓Restores disc height and relieves nerve pressure
✓Available for both the neck and the lower back
✓Often outpatient or short-stay
✓A real alternative for many patients told they need a fusion
Conditions Treated With Artificial Disc Replacement
Degenerative disc disease at a single level
Herniated disc causing arm or leg pain
Cervical disc disease with neck and radiating pain
I was told I need a fusion. Could disc replacement work instead?
Sometimes, yes. Many patients come to Dr. Melamed with a fusion recommendation. If the disc is the problem and the segment is otherwise stable, without significant arthritis of the small joints or deformity, a disc replacement may relieve the pain and keep the level moving. He reviews your imaging to see which group you fall into.
How is disc replacement different from a fusion?
A fusion joins two vertebrae into one solid unit, ending motion at that level. Disc replacement removes the worn disc and puts a mobile implant in its place, so the segment keeps moving. Both can relieve pain — the key difference is whether motion is preserved.
Am I a candidate for disc replacement instead of fusion?
It depends on your anatomy. Disc replacement works best when the disc itself is the problem and the segment is otherwise stable, without significant arthritis or deformity. Dr. Melamed reviews your imaging to determine which approach will actually solve your pain.
Can both neck and lower back discs be replaced?
Yes. Artificial disc replacement is performed in both the cervical spine and the lumbar spine. The right level and the right candidacy are confirmed on a case-by-case basis.
Second opinions welcome
Not sure if surgery is the answer? Neither are we — until we've seen your MRI.
Send your imaging for a personal review with Dr. Melamed. Many patients learn a smaller, muscle-sparing option is on the table.
