Surgical technique for a cervical disc arthroplasty

Abstract

Total disc replacement in the cervical spine is an excellent treatment for patients with symptoms of cervical radiculopathy or myelopathy with concordant findings on advance imaging studies (computed tomography (CT) myelogram or magnetic resonance imaging (MRI)) at two or fewer levels. For operative planning, upright anterior-posterior (AP), lateral, flexion, and extension radiographs should be obtained. To be a candidate for a CDR, patients should have a neutral or lordotic cervical spine without significant spondylosis. Specifically, patients should have no bridging osteophytes, signs of instability, or loss of more than 50% of the disc height at a normal level. Additionally, it is critical that all compression is at the intervertebral disc space, because the decompression for a CDR does not allow for resection of portions of the vertebral body. For patients who meet these criteria, a cervical disc replacement can provide excellent improvements in health-related quality of life.