Surgery to remove a cervical disc herniation is called a microdiscectomy, because the operating microscope is used to minimize the length of the incision and to improve the precision of the procedure. It can be performed from the front (anterior) or the back (posterior). When the anterior approach is used, the entire disc is usually removed, and the disc replaced with a graft. Formerly the graft was a piece of bone surgically removed from the hip. This resulted in excellent fusion rates, but the bone graft incision was often a source of significant pain. Now, synthetic grafts combined with a product known as Infuse®, a compound which stimulates bone growth without an actual bone graft, are used with excellent fusion rates, eliminating the pain associated with a bone graft. Usually a thin titanium plate is affixed to the vertebra to lock the graft in position, minimizing the need for wearing a collar around the neck, and allowing early neck mobilization.

When the posterior approach is used, a small opening in the bone is created with a drill, allowing the disc fragment to be removed. This usually does not require a fusion, but does result in more immediate pain after surgery, though this improves during the days and weeks after surgery.

With both of these approaches, the relief of arm pain is usually prompt, and often immediate. Moderate restrictions after surgery are recommended, followed by a few weeks of rehabilitation, often consisting simply of some self-directed exercises.