Artificial cervical disc replacement is an option for patients with symptomatic cervical disc disease.
The historical choice has been to perform a discectomy (disc removal) and fuse the spine with bone and/or a plate. The concern is that fusion may place added stress at the level above and below the fusion and eventually lead to additional surgery in the future.
The advantage of the disc replacement is that by allowing motion at the surgical level, there may not be added stress placed on the levels next to the replacement. This could decrease the need for additional surgery in the future.
Criteria for artificial cervical disc replacement are:
- Age between 18-60 years
- Symptomatic disc disease at one level in between C3-7
- With neck or arm pain and
- Disc herniation
- Disc degeneration with bone spurs
- Loss of disc height
- Failed non-surgical treatment
- Neck Disability Index (NDI) greater than or equal to 30%
The NDI is a 10 question rating system to determine loss of function due to symptomatic disc disease.
It is helpful to help patients and doctors understand the extent of the disease and also to educate patients with respect to realistic expectations regarding treatment of their problem.
Ask your doctor if he uses it.
A recent published multicenter FDA study on the cervical disc replacement (PRODISC-C) concluded that the disc replacement is a safe and effective surgical treatment of symptomatic disc disease in the neck. It is equal or superior to fusion. **
Long-term results (greater than 5 years) in the United States are still unknown.
Only a few insurance companies currently authorize their use.
**Murrey, D. et al. The Spine Journal: 2009: 9: 275-286