Cervical Disc Arthroplasty
Cervical disc arthroplasty is also known as total disc arthroplasty. It has become an FDA approved option for surgically treating symptomatic cervical disc disease. This procedure is quite similar to the anterior cervical discectomy and fusion. However, the defect that is created by removing disc from between two vertebrae is filled with a disc replacement device.
A disc replacement device is typically composed of two metallic surfaces. One of these surfaces is attached to upper and other to the lower vertebra at the affected disc level. These metal implants can then slide on each other directly. They can also be separated by a piece of medical grade plastic. The device allows for motion between the two vertebrae to be maintained and avoids the need for a fusion.
Cervical disc arthroplasty can be used to preserve motion of the segment and decrease the incidence of adjacent segment disease. It has been developed as an alternative to anterior cervical discectomy and fusion in the surgical treatment of degenerative disc disease. Overall, the clinical outcomes of cervical disc arthroplasty in other studies have been acceptable.
Although the main advantage of the cervical disc replacement was supposed to be a decrease in adjacent segment disease compared to cervical fusion surgery, ACDF. While some studies have demonstrated a decreased incidence of adjacent segment disease, most of the larger studies have been inconclusive.
It is important to understand that total disc replacement is a new procedure. It has less of a track record than the more traditional anterior cervical discectomy and fusion surgery. Cervical total disc replacement has only been available in the United States for the past several years. However, the procedure has been performed in Europe for more than 20 years. More data on disc replacement is being generated every year. Both patients and physicians must understand that this is a newer surgical option with longer term results that will need to be watched closely.
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