Cervical Disc Arthroplasty — A Clinical Review

Abstract

Anterior cervical discectomy and fusion (ACDF) has long been considered the gold standard for treating myelopathy and radiculopathy due to disk degeneration. One major complication of this procedure is adjacent segment degeneration. Cervical disc arthroplasty (CDA) has been proposed as an alternative to ACDF and as a means to reduce ASD. This chapter briefly recounts the advent of CDA. Additionally, it describes the most common implants and biomechanical properties associated with those designs. Critical to CDA is meticulous operative technique including implant positioning and hemostasis. Data in the form of FDA IDE studies and more recent meta-analyses of existing studies have demonstrated non-inferiority of CDA when compared to ACDF. This chapter also reviews the most common complications associated with CDA including heterotopic ossification and ankylosis of the involved segment. While more technically demanding than ACDF, CDA does represent a viable alternative in the proper patient.