Cervical disc arthroplasty: tips and tricks
- 144 Downloads
Cervical disc arthroplasty (CDA) is a powerful, motion-sparing treatment option for managing cervical radiculopathy or myelopathy. While CDA can be an excellent surgery for properly indicated patients, it is also less forgiving than cervical fusion. Optimally resolving patient symptoms while maintaining range of motion relies on near perfection in the surgical technique. Different CDA options exist on the market, with some having long-term proven success and others in early stages of clinical trials. We discuss the different options available for use, as well as strategies of positioning, approach, disc space preparation, implantation, and fusion prevention that we believe can help improve performance and outcomes of CDA.
KeywordsCervical disc arthroplasty Cervical disc replacement Artificial disc replacement
Compliance with ethical standards
This article does not contain any studies with human participants or animals performed by any of the authors.
Conflict of interest
The authors declare that they have no conflict of interest.
- 8.Radcliff K, Zigler J, Zigler J (2015) Costs of cervical disc replacement versus anterior cervical discectomy and fusion for treatment of single-level cervical disc disease: an analysis of the Blue Health Intelligence database for acute and long-term costs and complications. Spine 40(8):521–529CrossRefPubMedGoogle Scholar
- 9.Radcliff K, Davis RJ, Hisey MS, Nunley PD, Hoffman GA, Jackson RJ, Bae HW, Albert T, Coric D (2017) Long-term evaluation of cervical disc arthroplasty with the Mobi-C cervical disc: a randomized, prospective, multicenter clinical trial with seven-year follow-up. Int J Spine Surg 11:31CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Ghobrial GM, Lavelle WF, Florman JE, Riew KD, Levi AD (2018) Symptomatic adjacent level disease requiring surgery: analysis of 10-year results from a prospective, randomized, clinical trial comparing cervical disc arthroplasty to anterior cervical fusion. NeurosurgeryGoogle Scholar
- 15.Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M (2013) ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative dis disease: five-year results of a Food and Drug Administration study. Spine 38(3):203–209CrossRefPubMedGoogle Scholar
- 17.Janssen ME, Zigler JE, Spivak JM, Delamarter RB, Darden BV, Kopjar B (2015) ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration investigational device exemption study. J Bone Joint Surg Am 97(21):1738–1747CrossRefPubMedGoogle Scholar
- 20.Lanman TH, Burkus JK, Dryer RG, Gornet MF, McConnell J, Hodges SD (2017) Long-term clinical and radiographic outcomes of the Prestige LP artificial cervical disc replacement at 2 levels: results form a prospective randomized controlled clinical trial. J Neurosurg Spine 27(1):7–19CrossRefPubMedGoogle Scholar
- 22.Vaccaro A, Beutler W, Peppelman W, Marzluff JM, Highsmith J, Mugglin A, DeMuth G, Gudipally M, Baker KJ (2013) Clinical outcomes with selectively constrained SECURE-C cervical disc arthroplasty: two-year results from a prospective, randomized, controlled, multicenter investigational device exemption study. Spine 38(26):2227–2239CrossRefPubMedGoogle Scholar
- 23.Vaccaro A, Beutler W, Peppelman W, Marzluff JM, Mugglin A, Ramakrishnan PS, Myer J, Baker KJ (2018) Long-term clinical experience with selectively constrained SECURE-C cervical artificial disc for 1-level cervical disc disease: results from seven-year follow-up of a prospective, randomized, controlled investigational device exemption clinical trial. Int J Spine Surg 12(3):377–387CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Gornet MF, Lanman TH, Burkus JK, Hodges SD, McConnell JR, Dryer RF, Copay AG, Nian H, Harrell FE (2017) Cervical disc arthroplasty with the Prestige LP disc versus anterior cervical discectomy and fusion, at 2 levels: results of a prospective, multicenter randomized controlled clinical trial at 24 months. J Neurosurg Spine 26(6):653–667CrossRefPubMedGoogle Scholar
- 31.Hu Y, Lv G, Ren S, Johansen D (2016) Mid- to long-term outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease: a systematic review and meta-analysis of eight prospective randomized controlled trials. PLoS One 11(2):e0149312CrossRefPubMedPubMedCentralGoogle Scholar