Motion preservation in cervical spine: review

Area of Science:

• Orthopedics
• Neurosurgery
• Spinal Surgery

Background:

• Cervical disc replacement is an emerging technology for treating cervical radiculopathy and myelopathy.
• It aims to preserve motion at the operated spinal level, unlike traditional spinal fusion.
• Motion preservation may offer benefits over fusion, despite fusion's established efficacy.

Purpose of the Study:

• To evaluate cervical disc replacement as an alternative to anterior cervical fusion.
• To compare the safety and clinical success of arthroplasty versus fusion.
• To assess the potential of arthroplasty in preventing adjacent segment degeneration.

Main Methods:

• Review of randomized clinical trials comparing cervical disc replacement with anterior cervical fusion.
• Analysis of initial and midterm clinical outcomes, including safety and efficacy.
• Assessment of evidence regarding the prevention of adjacent segment degeneration.

Main Results:

• Randomized clinical trials show that cervical disc replacement is safe and clinically equivalent to anterior cervical fusion in initial and midterm follow-ups.
• Arthroplasty provides motion preservation at the instrumented level.
• Current evidence does not establish the superiority of arthroplasty over fusion in preventing adjacent segment degeneration.

Conclusions:

• Cervical disc replacement is a viable alternative to anterior cervical fusion, offering motion preservation.
• Short- to midterm results demonstrate comparable safety and clinical success.
• Further long-term studies are needed to determine if arthroplasty prevents adjacent segment disease more effectively than fusion.