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Anterior Cervical Discectomy and Fusion in the Ovine Model
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Cervical Disc Arthroplasty: Rationale and History
Peter B Derman1, Jack E Zigler1
1Texas Back Institute, Plano, Texas.
International Journal of Spine Surgery
|September 30, 2020
Summary
Cervical disc arthroplasty (CDA) offers an alternative to fusion surgery for degenerative disc disease. Modern CDA devices aim to preserve motion, potentially avoiding fusion complications like adjacent segment disease.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Spine Surgery
Background:
- Cervical fusion surgery can lead to increased stress on adjacent spinal levels.
- Degenerative disc disease often causes radiculopathy and myelopathy, necessitating treatment.
- Adjacent segment disease is a known complication of cervical fusion.
Purpose of the Study:
- To review the rationale behind cervical disc arthroplasty (CDA).
- To explore the historical evolution of CDA devices.
- To compare CDA outcomes with traditional fusion methods.
Main Methods:
- Review of biomechanical studies on cervical fusion.
- Historical analysis of CDA device development.
- Comparison of long-term outcomes between CDA and anterior cervical discectomy and fusion (ACDF).
Main Results:
- Cervical fusion increases motion and pressure at adjacent levels.
- Early CDA devices had suboptimal results.
- Recent CDA generations show outcomes comparable or superior to ACDF.
Conclusions:
- CDA is a viable alternative to ACDF for specific spinal conditions.
- Advancements in CDA technology have improved patient outcomes.
- Preserving segmental motion is a key advantage of CDA over fusion.