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Treatment of the painful motion segment: cervical arthroplasty
John B Pracyk1, Vincent C Traynelis
1Department of Neurosurgery, University of Iowa, Iowa City, IA, USA.
Study Design:
A retrospective review of the literature.
Objective:
This work serves as a comprehensive update of cervical arthroplasty.
Summary Of Background Data:
Cervical arthroplasty has developed as a means to preserve normal spinal motion after an anterior cervical discectomy. Preserving motion may lead to an acute improvement in patient outcome and may decrease the incidence of symptomatic adjacent segment disease in the long-term.
Methods:
The literature concerning the outcomes following anterior cervical decompression and fusion, the indications for cervical arthroplasty, the indications and contraindications for arthroplasty, the surgical technique, and early outcome studies for those devices currently in U.S. FDA IDE trials are reviewed.
Results:
The most data are available for the Prestige, Bryan, and ProDisc-C devices. While these devices all preserve normal segmental motion, the articulations vary (metal on metal, metal on polyurethane, and metal on ultra-high molecular weight polyethylene). Wear testing indicates that these devices will have a long life once implanted. Preliminary outcomes compare very favorably to anterior decompression and arthrodesis.
Conclusions:
Cervical arthroplasty is a promising new technology that may improve patient outcome following anterior cervical decompression.