Cervical disc arthroplasty: Pros and cons.
BACKGROUND
Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question.


METHODS
This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF.


RESULTS
Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications.


CONCLUSIONS
Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing.
Department of Orthopaedic Surgery, Johns Hopkins Medical Instititutions, 3333 N. Calvert St. Suite 400, Baltimore, MD 21218.
Bradley
B
Moatz
P Justin
PJ
Tortolani