Cervical intervertebral disc replacement.

Area of Science:

• Orthopedic Surgery
• Spinal Biomechanics
• Neurosurgery

Background:

• Symptomatic adjacent-level disease is a concern following cervical fusion.
• Cervical disc replacement (CDR) prostheses have been developed to address this issue.
• Anterior cervical discectomy and fusion (ACDF) is a common surgical treatment.

Purpose of the Study:

• To compare the clinical outcomes and complication rates of CDR versus ACDF.
• To evaluate the biomechanical and kinematic effects of CDR on the cervical spine.
• To investigate the potential of CDR to reduce adjacent spinal-level disease.

Main Methods:

• Randomized controlled trials comparing CDR and ACDF.
• Biomechanical, kinematic, and radiographic analyses of CDR.
• Assessment of intradiscal pressures adjacent to CDR.

Main Results:

• CDR demonstrated at least equivalent clinical results compared to ACDF.
• CDR showed similar or lower complication rates than ACDF.
• Biomechanical studies indicated CDR more closely mimics native spinal motion and center of rotation.

Conclusions:

• Cervical disc replacement is a viable alternative to ACDF with comparable or better outcomes.
• CDR's motion-preserving nature may decrease adjacent spinal-level disease incidence.
• Long-term follow-up is required to confirm the reduced incidence of adjacent segment pathology.