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Case library  /  C-04  ·  CERVICAL

C5-C6 artificial disc replacement

25-year-old man, work-related lifting. Severe neck pain, tingling and numbness, with right-arm weakness — three months of conservative care without relief.

BeforeAfter
Before treatment — de-identified imaging After treatment — de-identified imaging
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The films
Pre-op sagittal MRI — herniated disc — de-identified
Pre-op sagittal MRI — herniated disc
Pre-op sagittal MRI, second sequence — de-identified
Pre-op sagittal MRI, second sequence
Post-op lateral — artificial disc at C5-C6 — de-identified
Post-op lateral — artificial disc at C5-C6
Post-op AP — implant in place — de-identified
Post-op AP — implant in place
Where in the spine

The disc that moves your neck — kept moving.

C5-C6 is one of the neck’s workhorse levels, and the nerve leaving the spine here runs to the shoulder, arm, and hand — which is why a herniation at this disc shows up as arm tingling and weakness.

The implant replaces the damaged disc and keeps the level moving instead of fusing it solid.

C5-C6 — artificial disc, motion preserved
The course, in order
  1. Day 0Lifting injuryWork-related; neck pain with arm tingling, numbness, and weakness.
  2. Months 0–3Conservative careTherapy, medications, and injections — arm symptoms didn’t resolve.
  3. The decisionPreserve motionAt 25, keeping the level mobile mattered: disc replacement over fusion.
  4. SurgeryC5-C6 arthroplastyDamaged disc out, mobile implant in — nerve decompressed.
  5. AfterNo fusionThe level keeps bending; the arm symptoms had their cause removed.
The choice in this case — fusion vs. disc replacement
OPTION — ACDF (FUSION)
Motion at C5-C6: none

The standard operation removes the disc and locks the two vertebrae together with a spacer and plate. Reliable — but this level never moves again, and the levels above and below inherit its share of the work.

CHOSEN — ARTIFICIAL DISC
Motion at C5-C6: preserved

The disc is removed the same way, but a mobile implant takes its place. The nerve gets the same decompression while the joint keeps bending — the reason it was chosen for a 25-year-old neck.

Schematic, not to scale — the actual implant is visible in the post-op films above.

Presentation
Work-related lifting injury; severe neck pain with tingling, numbness, and right-arm weakness.
Imaging
MRI shows the herniated cervical disc pressing on the cord and root at C5-C6.
Decision
Therapy, medications, and injections for more than three months did not resolve the arm symptoms. At 25, preserving neck motion mattered — an artificial disc instead of a fusion.
What was done
C5-C6 cervical disc arthroplasty: the damaged disc is removed and replaced with a mobile implant, decompressing the nerve while keeping the level moving.
Motion preserved — no fusionNerve decompressedYoung, active patient
"The implant keeps the level moving — fusion isn't the only answer in a young neck."
All cases shown are real patients treated by Dr. Andrew Pugely, presented with de-identified imaging for education. Every spine — and every recovery — is different: individual results vary, and nothing on this page is a guarantee of outcome or a substitute for an in-person evaluation.
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