J Korean Med Assoc.  2011 Sep;54(9):941-950. 10.5124/jkma.2011.54.9.941.

Current concept on the operative treatment for degenerative cervical disc disease

• Jeon TS
• Chang H
• Choi BW

• KMID: 2191179
• DOI: http://doi.org/10.5124/jkma.2011.54.9.941

Abstract

Degenerative changes in the cervical spinal column are common in the adult population. Although most patients respond well to initial nonsurgical management, those who continue to have symptoms or patients with clinically evident myelopathy are candidates for surgical intervention. The objective of this article is to review and discuss the surgical treatment for degenerative cervical spine disease. Anterior cervical spine surgery is commonly used to treat numerous pathologic entities and is expected to increase with the development of surgical techniques and instruments. Autogenous tricortical iliac crest struts are the best option for anterior fusion, but they are associated with donor site morbidity. Equivalent fusion rates have been reported after allografting and autografting, combined with the use of anterior plates. Artificial disc replacement, one of the emerging motion-sparing technologies, is currently used and has shown excellent results. However, longer follow-up is needed to determine whether these devices can function well over time. Surgical treatments in degenerative cervical disease have shown excellent results. Appropriate methods that take into account the pathologic status of the patient and the surgeon's surgical experience can prevent complications and lead to excellent surgical outcomes.

Keyword

Herniated cervical disc; Cervical radiculopathy; Cervical myelopathy; Anterior cervical discectomy and fusion; Artificial disc replacement

MeSH Terms

Adult
Humans
Radiculopathy
Spinal Cord Diseases
Spine
Tissue Donors
Total Disc Replacement
Transplantation, Autologous
Transplantation, Homologous

Figure

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  Figure 1 Anterior cervical discectomy and fusion using autogenous tricortical iliac bone (arrow).

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  Figure 2 Anterior cervical discectomy and fusion using allogenous tricortical iliac bone.

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  Figure 3 Anterior cervical discectomy and fusion using polyetheretherketone cage filled with autogenous cancellous bone (A) without plate fixation, (B) additional plate fixation.

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  Figure 4 Anterior cervical discectomy and fusion using zero-profile implant with a stand-alone cage filled local bone.

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  Figure 5 Anterior transvertebral herniotomy.

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  Figure 6 Currently available artificial cervical disc in USA. (A) Prodisc-C, Synthes® (B) Prestige LP, Medtronic® (C) MobiC, LDR Medica® (D) Discover, DePuy® (E) M6, Spinal Kinetics® (F) ActivC, Aesculap® (G) Discovery, Scient'X® (H) Bryan, Medtronic®.

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  Figure 7 Postoperative plain radiographs of cervical disc replacement. Anteroposterior view (A).Flexion-extension lateral X-ray show motion at C5-6 level (B,C).

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