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Cervical arthroplasty: the beginning, the middle, the end?
O Richards1, D Choi, J Timothy
1School of Medicine, University of Leeds, Leeds, UK. um06or@leeds.ac.uk
British Journal of Neurosurgery
|August 6, 2011
Summary
Cervical arthroplasty offers motion preservation but faces complications. Long-term studies are needed to confirm if artificial discs reduce adjacent segment disease compared to spinal fusion.
Area of Science:
- Orthopedics
- Neurosurgery
- Spinal Surgery
Background:
- Cervical arthroplasty is an alternative to spinal fusion for cervical radiculopathy and myelopathy.
- Increased complications with spinal fusion (arthrodesis) have driven interest in artificial discs.
- Theoretical benefits include motion preservation and prevention of adjacent segment disease.
Purpose of the Study:
- To evaluate the current evidence for cervical arthroplasty versus spinal fusion.
- To assess the long-term efficacy and safety of artificial disc replacement.
- To determine if cervical arthroplasty can reduce adjacent segment disease.
Main Methods:
- Review of existing literature on cervical arthroplasty and spinal fusion.
- Analysis of reported complications, including heterotopic ossification and device migration.
- Evaluation of clinical outcomes and adjacent segment disease incidence.
Main Results:
- Promising short- and intermediate-term clinical outcomes for cervical arthroplasty.
- Growing reports of complications with artificial discs, including spontaneous fusion.
- Inadequate long-term evidence to support widespread use or discontinuation.
Conclusions:
- Further long-term randomized trials are necessary.
- Cervical arthroplasty's long-term benefit hinges on reducing adjacent segment disease.
- Arthroplasty has not yet replaced arthrodesis as the gold standard for cervical spondylosis.
