This exhibit depicts a C4-5 anterior cervical discectomy and total disc replacement. The procedure begins with an incision over the anterior neck, exposing C4-5. Distraction pins are placed and a midline C4-5 disc herniation is removed. Bilateral foraminotomies are then performed to decompress the cervical nerve roots. The vertebral endplates are decorticated with a high speed drill, and an artificial disc is impacted into the disc space. Screws are placed through the anterior portion of the artificial disc for stabilization.