**5. Surgical technique and pearls**

## **5.1 Patient positioning**

Patients commonly notice posterior neck pain following disc arthroplasty. The pain can be a result of surgical positioning, intraoperative distraction on the facet joints and capsules, or an indirect distraction on the endplates from the implant itself. Often these implants are inserted with a considerable amount of force so in order to limit the unsupported transfer of these forces to the paraspinal musculature and facet joints, a properly contoured support should be placed along the posterior aspect of the neck (**Figure 2a**).
