Update on cervical disc arthroplasty: where are we and where are we going?

Abstract

Despite the very good results of anterior cervical discectomy and fusion, there are concerns of adjacent level degeneration. For this reason, interest has grown in the potential for motion sparing alternatives. Cervical disc arthroplasty is thus evolving as a potential alternative to fusion. Specific design characteristic and implants will be reviewed and outcomes summarized.

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

“…The IAR identifies the rotation of one vertebra relative to another at a given point in time and will change when the motion of the vertebral body consists of both a translational and a rotational component. Artificial cervical discs should have an axis of rotation that mimics the kinematics of the normal spine to restore the physiologic range of motion and disc height and to transmit axial loading forces from the superior to the inferior vertebral body [36]. Some arthroplasty devices, like the DISCOVER Ò and the ProDisc-C, have a ball-and-socket single-articulating design with a fixed center of rotation (COR).…”

Safety and Effectiveness of Bone Allografts in Anterior Cervical Discectomy and Fusion Surgery

“…6 Indeed, clinical trials of cervical disc arthroplasty versus the current gold standard, ACDF with allograft, have demonstrated similar shortterm clinical benefi t in patients with symptomatic cervical disease. 7 -9 However, despite recent marketing approvals by US regulators of several artifi cial cervical discs, arthroplasty remains a new technique with limited long-term patient data available.…”

Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multicenter clinical trial

“…9,49 Cervical TDR is an attractive alternative to anterior cervical discectomy and fusion (ACDF) because it achieves neural decompression via an identical anterior surgical approach while preserving mobility and achieving comparable clinical success. 25,41,42 A primary rationale for the use of TDR has been the hypothesis that by preserving mobility at the operated segment, TDR will allow for normal cervical spine biomechanics and thereby maintain the integrity of adjacent segments. 24,41 While the goal of ACDF is to eliminate mobility in the treated segment, 2,3 this loss of mobility has been shown to induce hypermobility and to increase stress and intradiscal pressures on the segments adjacent to fused segments.…”