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Reverse Total Shoulder Arthroplasty
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Cervical Total Disk Arthroplasty.

Timothy T Roberts1, Ryan J Filler2, Jason W Savage1

  • 1Center for Spine Health at the Neurological Institute, Cleveland Clinic, Cleveland, OH.

Clinical Spine Surgery
|January 10, 2018
PubMed
Summary
This summary is machine-generated.

Cervical total disk arthroplasty (TDA) aims to preserve motion and reduce pain for cervical disk disease. However, its superiority over traditional fusion and its ability to prevent adjacent segment disease remain debated.

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Area of Science:

  • Spine surgery
  • Orthopedic biomechanics
  • Degenerative disc disease treatment

Background:

  • Cervical total disk arthroplasty (TDA) is FDA-approved for 1-2 level cervical disk disease causing myelopathy/radiculopathy.
  • Various TDA designs exist, differing in form, function, materials, and in vivo performance.
  • Therapeutic goals include pain relief, motion preservation, and mitigating adjacent segment disease (ASDis).

Purpose of the Study:

  • To review the current evidence on cervical total disk arthroplasty (TDA).
  • To compare TDA designs and their clinical outcomes.
  • To evaluate the efficacy of TDA versus anterior cervical discectomy and fusion (ACDF).

Main Methods:

  • Review of available clinical evidence and studies on cervical TDA.
  • Comparison of different TDA designs (e.g., ball-and-socket, ball-and-trough, elastomeric).
  • Analysis of TDA's effectiveness in pain reduction, motion preservation, and prevention of adjacent segment disease (ASDis).

Main Results:

  • No single TDA design philosophy is currently favored by clinical evidence.
  • Cervical TDA is comparable to anterior cervical discectomy and fusion (ACDF) in reducing pain and neurological symptoms.
  • Evidence supporting TDA's reduction of symptomatic adjacent segment disease (ASDis) is unclear and disputed, despite some radiographic evidence.

Conclusions:

  • Cervical TDA is a viable option for specific cervical disk conditions, offering pain relief similar to ACDF.
  • The long-term clinical benefit of motion preservation and prevention of symptomatic adjacent segment disease (ASDis) with TDA requires further investigation.
  • The controversy regarding TDA's superiority over ACDF persists due to unclear evidence on symptomatic adjacent segment disease (ASDis).