New Study Identifies Factors Affecting Patient Outcomes After Cervical Disc Replacement (CDR)

Minimally Invasive Spine Surgery

Cervical disc replacement (CDR) has become a promising treatment option for individuals suffering from degenerative cervical spine issues. However, it may not be right for every one, and success isn’t guaranteed.

In a study recently published in The Spine Journal researchers at HSS reviewed the outcomes of 154 patients who underwent cervical disc replacement (CDR). The goal was to identify factors that negatively impact surgical success.

This research was conducted by reviewing patient reported outcome (PROM) data from patients who had undergone 1- or 2-level CDR surgery for degenerative cervical spine issues between 2017 and 2022. The study looked at various factors, including patient demographics, medical history, diagnoses, symptoms, and surgical characteristics, to identify what might influence the success of CDR surgery.

Key Findings

  • Predominant Neck Pain: Patients whose most significant complaint was neck pain (instead of arm pain) were found to be at risk of not achieving significant improvement in the post-operative periods. This means that if your primary symptom is neck pain, there’s a chance that your improvement after CDR may be limited.
  • Myelopathy: Patients with myelopathy, a condition characterized by spinal cord dysfunction, were at risk of not achieving improvement the early post-operative period. This suggests that individuals with myelopathy may experience slower improvements in neck pain after surgery.
  • Anxiety: Patients with anxiety lacked significant improvement late post-operative period. This indicates that psychological factors, such as anxiety, can play a role in the success of CDR surgery.
  • CDR at Levels C5-C7: Having CDR surgery at levels C5-C7 was associated with lack of improvement in the late post-operative period. If your surgery involves these specific cervical levels, it may be more challenging to achieve significant neck pain relief.

If you are considering CDR, it may be worthwhile having a conversation with your healthcare provider if any of these factors apply to you.


Mai E, Shahi P, Md RL, et al. Risk factors for failure to achieve minimal clinically important difference following cervical disc replacement [published online ahead of print, 2023 Sep 1]. Spine J. 2023;S1529-9430(23)03367-3. 

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for