Artificial Disc Replacement Canada
Choosing between artificial disc replacement and spinal fusion is rarely a simple decision. People researching these options often want to understand which operation suits their spine, and which surgeon has performed enough of these procedures to judge that with confidence.
Prof. Dr. Rudolf Bertagnoli is a Consultant Orthopedic Spine Surgeon who currently operates from Germany and has performed more than 10,000 cervical and lumbar disc replacement procedures. People researching artificial disc replacement in Canada may consider his experience when comparing treatment options or seeking another opinion. He treats patients from many countries, and anyone can request an individual case evaluation, currently free of charge, with their history and imaging reviewed together before deciding whether ADR surgery is appropriate.
Prof. Dr. Bertagnoli has treated patients from Canada with a range of cervical and lumbar spine conditions. These have included cervical and lumbar artificial disc replacement, multi-level ADR and complex revision treatment. Such cases reflect the different reasons Canadian patients seek an individual specialist evaluation before deciding on treatment.
Medical history and symptoms are enough to begin the process, and available imaging can be added for review.
Prof. Dr. Bertagnoli's Experience in Disc Replacement
Prof. Dr. Bertagnoli's clinical work centres on Artificial Disc Replacement Surgery and other motion preserving techniques rather than general orthopaedics. It spans cervical and lumbar disc arthroplasty, multi-level cases, complex degenerative conditions, revision surgery and deformity correction, and he has contributed to spinal implant and instrument design and holds 37 international patents.
His published research includes 81 scientific publications and work as an investigator in 16 clinical studies. He has delivered more than 280 surgical training courses and over 600 lectures internationally, and trained more than 3,500 spine surgeons from over 55 countries. Further detail is set out in his CV and professional background.
What Artificial Disc Replacement Involves
Artificial disc replacement, also called total disc replacement (TDR) or total disc arthroplasty (TDA), replaces a worn spinal disc with a device designed to move. A spinal disc sits between two vertebrae and works as both a cushion and a hinge, and when it degenerates it can lose height and change how load passes through that segment. Because the indications differ between the cervical and the lumbar spine, the two are assessed separately.
Cervical Disc Replacement
Cervical disc replacement treats discs in the neck through a small incision at the front of the neck. It may be considered for selected patients with appropriate cervical disc disease where symptoms and imaging match, including arm symptoms from nerve root compression and, in selected cases, spinal cord pressure.
Lumbar Disc Replacement
Lumbar disc replacement treats discs in the lower back through an approach at the front of the abdomen. It is directed at selected patients with appropriately diagnosed symptomatic degenerative disc disease and discogenic low back pain. It is not a general treatment for lumbar disc herniation, sciatica or leg pain, and pain from nerve root compression is assessed separately, as it is often addressed differently.
Patient Experiences from Canada
Prof. Dr. Bertagnoli has treated Canadian patients with a range of cervical and lumbar spine conditions, including multi-level and revision cases. The accounts below are the patients' own descriptions of their treatment and recovery.
Brandon Cleverley
Brandon had experienced worsening back problems over several years and had been considering spinal fusion. After an evaluation with Prof. Dr. Bertagnoli, he underwent a complex multi-level artificial disc replacement. In his own account he describes improvement in pain, mobility and strength through his recovery.
→ Read Brandon Cleverley's Full Story
First I would like to say thank you again to Dr.Bertagnoli, the staff at ProSpine and the staff at Bogen hospital. You made this a very positive experience for both me and my wife. Not once did we feel uncomfortable being so far away from home. For once we were treated how a patient should be treated.
My problem started six years ago here in Canada. The pain started very mild but progressively became worse. Slowly taking away our life. Over those six years we struggled to get any support from our healthcare system for a solution to my problem. We were constantly told it could not be fixed.
We learned about ADR surgery from a physiotherapist that I was using at the time but we could not find a surgeon who would even meet with me to discuss the matter. I had 13 Canadian surgeons refuse to help me or even see me in their office. After a trip to the emergency room shortly before our trip to Germany I was finally offered a single level fusion leaving me with the three other levels damaged.
When we presented the solution offered by Dr.Bertagnoli to a leading ADR facility in Ontario I was told it wasn't possible and that when we got to Germany they would tell us I wasn't eligible for 4 level ADR but here I am with everything going as planned.
Everyday is becoming better than the last, the pain keeps decreasing, my mobility keeps improving and for once my back is feeling stronger. My family has even commented how much happier I am since the surgery.
I would highly recommend Dr.Bertagnoli to anyone who needs help with their back. If one of my kids ever ended up with a back condition ProSpine would be the first and only place we would contact.
If anyone has any further questions about our journey to Germany please feel free to email me at
Once again thank you for all of your help.
Brandon Cleverley
T. Wu from Toronto
T. Wu, from Toronto, had degenerative cervical disc disease and a previous C5-C6 cervical fusion. When symptoms returned and further cervical disc problems were identified, he sought treatment from Prof. Dr. Bertagnoli and underwent three-level cervical artificial disc replacement. He later described maintaining neck mobility and steady progress at follow-up.
Dr. Sterling Desmond from British Columbia
Dr. Sterling Desmond, a Canadian physician from British Columbia, had degenerative cervical disc disease, a previous cervical fusion and continuing symptoms. His treatment with Prof. Dr. Bertagnoli involved a complex cervical revision at C3-C4 and artificial discs at C4-C5 and C6-C7, with an existing C5-C6 fusion left in place. He reported substantial improvement following treatment.
→ Read Dr. Sterling Desmond's Full Story
Terri Kwiatkowsky from Alberta
Terri Kwiatkowsky, from Alberta, was treated by Prof. Dr. Bertagnoli. Her account focuses on a positive recovery experience and steady progress toward returning to normal daily life, rather than the technical details of her treatment. She describes the experience in her own words.
→ Read Terri Kwiatkowsky's Full Story
Paul Shantz
Paul Shantz travelled from Canada for treatment with Prof. Dr. Bertagnoli. His care involved two-level artificial disc replacement with DSS stabilisation, in place of the fusion that had also been considered. He returned to Canada and described continued recovery, and his account also notes a minor incision infection that lengthened his hospital stay.
→ Read Paul Shantz's Full Story
Debbie B.
Debbie B. had long-term lumbar problems after a workplace injury and had tried physiotherapy, medication and spinal injections. She later sought treatment from Prof. Dr. Bertagnoli and underwent three-level artificial disc replacement. In her own account she describes working through recovery and eventually returning to work as a Registered Nurse.
These are individual patient experiences. Diagnosis, treatment recommendations, recovery and results vary for each patient.
Disc Replacement Compared With Spinal Fusion
Both operations have a place. Disc replacement aims to preserve movement at the treated level. Fusion intentionally removes movement there to create stability, and may be the more appropriate treatment depending on the diagnosis, spinal stability, facet joint condition, bone quality, anatomy and any deformity.
Neither operation is automatically better, and disc replacement is not suitable for every spine. The right choice follows the individual diagnosis and the findings on examination and imaging, rather than a general preference.
Who May Be Considered for Disc Replacement
Disc replacement is not a treatment for neck or back pain in general. It may be considered where symptoms trace to a specific level and have not settled after a reasonable period of non-surgical treatment, and candidacy requires both clinical and imaging evaluation.
Factors Assessed During Candidacy Review
Assessment takes account of the diagnosis, symptom pattern, imaging findings, bone quality, spinal stability, facet joint condition, alignment, the number of levels, previous surgery, overall health and the implant proposed. Imaging alone does not determine candidacy, since degenerative changes appear on the scans of many people with no symptoms.
When Disc Replacement May Not Be Suitable
Active infection, inadequate bone quality, significant spinal instability, such as a spondylolisthesis may make disc replacement inappropriate or contraindicated, depending on the patient and the specific device. Marked deformity and some previous operations at the same level may also make it unsuitable. Because indications and contraindications differ between devices, suitability is assessed individually rather than against a fixed list, and fusion, a hybrid procedure or continued non-surgical care may be more appropriate.
An evaluation can begin with medical history and symptoms, with available scans submitted for review.
Submit Medical Information and Imaging
Multi-Level, Hybrid and Revision Procedures
More than one level may sometimes be evaluated, but each is assessed individually, and suitability at one level does not mean suitability at another. Where one level can accept a mobile implant while an adjacent level requires stabilisation, a hybrid procedure may combine both in a single operation. Revision surgery adds complexity, since scar tissue, existing implants and alignment changes affect what can realistically be achieved. Not every previous fusion can be revised, not every earlier artificial disc can be exchanged, and not every revision patient is suitable, so earlier operative records make the assessment more reliable.
How Artificial Disc Implants Are Selected
Prof. Dr. Bertagnoli has worked with a range of artificial disc replacement models and has contributed to implant design. No single implant suits every patient. Selection depends on whether the cervical or lumbar spine is treated, anatomy, bone quality, spinal movement, facet joint condition, the number of levels, previous surgery and the clinical goal. The implant forms part of the treatment plan rather than being decided in advance.
The Evaluation Process
Starting an Evaluation
The team can be contacted online or by phone, and the online case evaluation is currently free of charge. Medical history and symptoms can be submitted to begin, and available imaging added. Not every requested scan is needed first, and submitting imaging does not mean surgery will be recommended.
Imaging and Tests That May Be Requested
An MRI and upright X-rays are commonly requested. A CT scan may be requested where metal from previous surgery affects MRI quality. EMG or nerve conduction studies are sometimes requested, and bone density testing is relevant for lumbar disc replacement and may be requested before lumbar surgery. Further tests may be needed before any recommendation.
Case Review and Possible Outcomes
Submitted material is assessed before Prof. Dr. Bertagnoli reviews the case. His approach to evaluations considers symptoms, medical history, examination findings where available and imaging together, rather than scans in isolation. Where treatment is appropriate, a treatment plan may be prepared and a personalised cost estimate follows. An evaluation does not always lead to surgery: it may find that disc replacement is appropriate, that fusion or another procedure fits better, that further testing is needed, that non-surgical care should continue, or that surgery is not currently appropriate.
Surgery, Recovery and Follow-Up
What Generally Happens During Surgery
Disc replacement is performed under general anaesthesia. The disc is removed through an approach at the front of the neck or the abdomen, the space is prepared, and the implant is positioned and checked. Operating time and hospital care depend on the level treated, the number of levels and whether the case is a revision.
Recovery and Follow-Up
Recovery varies between patients and is not the same in every case. Early recovery usually involves reduced activity, with guidance on avoiding heavy lifting and repeated bending or twisting. Rehabilitation is planned individually and often staged, and the pace of return to work depends on the individual, the level treated and the type of work. Follow-up reviews, imaging and rehabilitation form part of the treatment plan, and where any continue closer to home the arrangements are agreed individually before discharge rather than on a fixed schedule.
Risks and Limitations
Every spinal operation carries risk, and disc replacement does not prevent all future spinal problems. Recognised risks include infection, bleeding, nerve injury, implant loosening or movement, unwanted bone formation, continuing or new pain, and further surgery. The cervical approach can affect swallowing or the voice, and the lumbar approach passes close to major blood vessels, carrying a risk of vascular injury and, in men, retrograde ejaculation. The risks relevant to an individual case are discussed before consent. However, complication rates are below one percent for Prof. Dr. Bertagnoli’s patients.
Personal accounts are available in the patient reviews and patient video sections. These are individual experiences and are not a guide to the risks, recovery or outcome of any particular case. These patient recounts are volutary and not edited, except for the occasional punctuation.
Artificial Disc Replacement Cost
Artificial disc replacement cannot be quoted as a single figure. The final cost depends on the individual treatment plan and several clinical and hospital factors, including the following.
- Whether the cervical or lumbar spine is treated.
- The number of spinal levels involved.
- Implant selection for the individual case.
- The complexity of the condition.
- Whether the surgery is a primary, revision or hybrid procedure.
- Diagnostic tests requested during evaluation or after admission.
- Hospital care, including the length of stay.
- Anaesthesia and operating theatre time.
- Follow-up requirements.
How a Personalised Estimate Is Prepared
A personalised estimate is prepared once the medical information and imaging have been reviewed and a treatment plan proposed, so the figures reflect the procedure recommended rather than a general price list. Cover for elective surgery performed outside a patient's home country varies between insurers, so individual arrangements are worth checking. Estimates follow the case evaluation.
A treatment plan and personalised cost estimate follow the review of medical information and imaging.
Request a Treatment and Cost Estimate
Why Some Canadian Patients Consider Treatment Outside Canada
Canada's healthcare is publicly funded, financed mainly through taxes and administered separately by each province and territory, as described by Health Canada. Eligible residents generally do not pay directly for medically necessary hospital and physician services, although this does not mean that every treatment is covered or that care is free. Access and waiting times vary considerably depending on the province, the specialist, the diagnostic imaging required and the procedure. Reaching a specialist usually begins with a referral from a family doctor, and Statistics Canada's data on access to care describes waits for specialist consultations and imaging in terms of months and years rather than days.
Because of waiting times, the wish to reach a particular treatment or specialist, or the desire for a further opinion, some patients look beyond their home province, including outside Canada. A few choose to self-pay for treatment abroad even when publicly funded options exist at home, and provincial plans usually provide only limited coverage for elective care obtained outside Canada, with prior approval generally required.
For someone researching artificial disc replacement, this usually means seeking a specialist ADR evaluation and comparing options. An online case evaluation with Prof. Dr. Bertagnoli is one way to obtain an experienced opinion before any decision is made.
Choosing an Artificial Disc Replacement Surgeon
Comparing surgeons for artificial disc replacement is difficult, because published information is rarely comparable between practices and search results tend to return rankings rather than useful criteria. No surgeon is right for every patient, and the more helpful question is how closely a surgeon's ADR surgery experience matches the individual diagnosis.
Points worth reviewing include procedure-specific experience rather than general spinal surgery, separate cervical and lumbar expertise, multi-level and revision experience, how patient selection is handled, involvement in research and implant development, surgical teaching, whether risks and alternatives are explained openly, the hospital setting and how follow-up is planned. Prof. Dr. Bertagnoli's record covers many of these areas, including cervical and lumbar disc arthroplasty, multi-level and revision work, implant development and published research. Whether that experience fits a particular case is still decided by evaluation rather than assumed in advance.
Frequently Asked Questions
How can I request an artificial disc replacement evaluation?
An online case evaluation can be submitted through the website, currently free of charge. Medical history, symptoms and any available imaging are reviewed together, and travel is not required at this stage.
How do I request a second opinion?
By submitting medical records and existing imaging through the online case evaluation. A second opinion reviews the diagnosis and the imaging, and may confirm a previous recommendation or set out a different option.
What imaging may be required?
An MRI and upright X-rays are commonly requested. A CT scan, EMG or nerve conduction studies and bone density testing may be requested where clinically appropriate. An evaluation can begin before all imaging has been obtained.
What is the difference between cervical and lumbar disc replacement?
The regions differ and so do the indications. Cervical disc replacement addresses appropriate cervical disc disease where symptoms and imaging match. Lumbar disc replacement is directed at selected patients with symptomatic degenerative disc disease and discogenic low back pain.
Can more than one spinal level be treated?
More than one level may be evaluated. Multi-level ADR surgery is quite common among Prof. Dr. Bertagnoli’s patients. He has done as many as five levels in the cervical and lumbar spine.
How much does artificial disc replacement cost?
The cost depends on the region treated, the number of levels, implant selection, case complexity, hospital care and whether the procedure is primary, revision or hybrid. A personalised estimate follows the review of medical information and imaging.
Request an Evaluation
A case evaluation is the starting point for understanding whether artificial disc replacement may be appropriate. Online case evaluations are currently free of charge. The process reviews medical history and existing imaging, and does not commit anyone to an operation or mean that surgery will be recommended. General information about the procedure is available on the artificial disc replacement overview page.
Submit medical information and available imaging for review.
Prefer to ask questions first? Contact the team.
Important Notes
Patient written and video testimonials are the opinions of the individual patients, and many are from doctors and other medical professionals. They are personal experiences, and results vary from one patient to another.
Prof. Dr. Bertagnoli seeks the most appropriate treatment for each patient. Every patient is different, so conditions, treatments and recovery vary. Not every patient is an artificial disc replacement patient, and complex cases may require additional or combined procedures.
