C6-7 Anterior Cervical Discectomy and Arthroplasty Guidelines

Clinical Justification for Surgical Intervention

The American Academy of Neurosurgery recommends anterior cervical discectomy and arthroplasty for patients with persistent radiculopathy despite comprehensive conservative management, with a success rate of 80-90% for arm pain relief 1, 2, 3
A minimum of 6 weeks of conservative therapy is required before surgical consideration, including over-the-counter anti-inflammatories, prescription medications, muscle relaxers, activity modification, regular icing, and physical therapy 3, 4

The American College of Surgeons recommends cervical arthroplasty as an alternative to ACDF in selected patients for control of neck and arm pain, with Class II evidence 1, 2, 6
Arthroplasty is equivalent to ACDF for 1-level disease with regard to functional outcomes, and preserves segmental motion, reducing stress on adjacent levels 1, 2, 6

Flexion-extension radiographs are required to rule out segmental instability at C6-7, and to confirm the absence of contraindications such as inflammatory spondyloarthropathy, osteoporosis, or active infection 3, 4
An FDA-approved device must be used for arthroplasty 4

Anterior cervical discectomy and arthroplasty results in an 80-90% success rate for arm pain relief, with more rapid relief within 3-4 months compared to continued conservative management 3, 5
Functional improvement is achieved in 90.9% of patients following surgical intervention, with maintained segmental motion at the treated level 3, 4