Total Cervical Disc Replacement using Artificial Disc in Cervical Disc Herniations

Park, Jin Hoon; Hwang, Sang Won; Jeon, Sang Ryong; Rhim, Seung Chul; Roh, Sung Woo

Abstract

OBJECTIVE
Anterior discectomy and fusion(ACDF) is still the 'gold-standard' treatment for diseases of the cervical disc. However, concerns over adjacent level degeneration and loss of motion have led us to consider total disc replacement with artificial disc as an alternative solution. This study aimed to evaluate the clinical results and radiological changes after cervical artificial disc replacement.
METHODS
Twenty consecutive patients underwent cervical arthroplasty for radiculopathy and were assessed at 1 and 12 months. Clinical outcomes were assessed using a numerical rating scale(NRS) score for radicular pain. Radiological results were evaluated by cervical lordosis(Cobb's angle), cervical range of motion(ROM), segmental lordosis, segmental ROM and segmental ROM of adjacent disc levels.
RESULTS
The mean NRS scores of all patients were significantly improved from 8.0+/-1.2 to 1.3+/-1.9 after 12 months. Cervical lordosis was improved in all patients(preoperative mean lordosis score 14.5degrees+/-8.8; postoperative mean lordosis score at 12 months 25.3degrees+/-9.2). There was no intraoperative or postoperative complication.
CONCLUSION
Preliminary results showed excellent in clinical and radiological outcomes after at least 20 months follow-up period. It seems that the cervical arthroplasty can be considerd an alternative method for anterior cervical discectomy and fusion(ACDF) and has benefits for postoperative cervical motion maintenance.