Cervical arthroplasty as an alternative to arthrodesis following anterior decompression - self

experience of four different total disc replacement systems.

Opole, Poland;

Abstract:

Introduction:

The incidence of symptomatic adjacent segment degeneration requiring further surgery following cervical

fusion is estimated as high as 3% per level/per year. That is the reason for looking for the alternative to this

more and more common in world statistics procedure. Cervical arthroplasty should help to avoid overload of

adjacent segments and its further degeneration.

Methods:

Four different cervical total disc replacement systems have been employed in Opole since the beginning of

2004. In the present study we retrospectively review our own rules of patient qualification to this procedure,

discuss the intraoperative technical problems and perform the early radiological and clinical outcome

evaluation.

Results:

During the past five years 566 anterior procedures were performed in Opole due to cervical discopathy.

Among this group 83 patients underwent a total of 89 cervical disc replacements. The early radiological

evaluation confirms the maintenance of motion in every employed system. Early clinical results are

comparable to good outcomes attained by fusion procedures.

Conclusions:

Our early results let us hope that combining of anterior cervical decompression with arthroplasty could

advantage in quicker convalescence without the need for plating and fusion, bone grafting or cervical

immobilization in a collar. The longevity and long term benefits of cervical arthroplasty remain to be seen.

:

Medtronic 5; Synthes 5; Johnson and Johnson 5.