Cervical disc replacement surgery involves removing the damaged disc and inserting an artificial disc between the cervical. There are different designs of artificial discs, but usually the artificial disc comprises two metal plates that move about a central core. The core may be metal or some other material.  One plate is attached to the lower vertebra and the other to the upper vertebra in the affected cervical region.

Although an ACDF is an old and well-accepted procedure, it has some drawbacks. It stops motion in the affected level, often resulting in less flexibility in the neck. Because it stops motion at one or more levels of the spine, the remaining discs do more work, which may result in another disc wearing out and requiring more surgery down the road. Also, it takes time, up to a year, for a fusion to become solid. Contrary to a fusion, which is supposed to stop all motion at the affected level, the artificial disc mimics the motion of a normal disc. There is some evidence that this results in less stress to the surrounding discs and lessens the chance of another disc wearing out. Also, since a fusion is not performed, the recovery is faster.

The artificial cervical disc was first approved for use in the USA in 2007. Artificial discs had been used in other countries for a number of years prior to that. These discs are typically used for on disc level, but there is at least one artificial disc brand that is approved for two levels. Artificial discs are indicated for herniated discs resulting in nerve compression.