Sergey Sergeev, MD, Pavel Kaydarov, MD.

Samara, Russia, 2008.

Artificial cervical disc technologies are being of degeneration of adjacent disc levels of the spine (developed in an effort to treat symptomatic degenerative disc disease more effectively). The main goal of this type of technology is to maintain spinal motion following anterior discectomy, to reduce the incidence adjacent-segment disease, and to permit more rapid return to normal activity.

The history of artificial discs count more than 28 years. In 1980 Brian Cummins developed the first Bristol –Cummins disc (UK). To 1991 Cummins implanted the Bristol –Cummins in 20 patients.

Today, there are 4 "types" of artificial discs and 3 generations. They include composite, hydraulic, elastic and mechanical discs. Composite discs is made of a polyethylene spacer and two separate metal endplates and comes in different sizes. Hydraulic artificial disc have a gel-like core covered with a tightly woven polyethylene "jacket". Elastic type artificial discs are made of a rubber core bonded to two titanium endplates. Mechanical discs has metal-metal or polyethylene core.

The indications for a cervical disc replacement are generally the same as for a cervical discectomy and fusion. A person must have a symptomatic cervical disc, which may be causing arm pain, arm weakness or numbness with some degree of neck pain, uneffective of non-operative treatment for at least 4 to 6 weeks, usually consisting of anti-inflammatory medication and physical therapies. These symptoms may due to a herniated disc and/or osteophytes compressing adjacent nerves or the spinal cord.

Conraindication: active systemic infection or infection localized to the site of implantation, osteopenia or osteoporosis, bony cervical spinal stenosis, allergy or sensitivity to implant materials (cobalt, chromium, molybdenum, polyethylene, titanium), spinal instability.

The potential complications with an artificial device are at least similar to an anterior cervical discectomy and fusion. Complications: infection, blood loss, nerve injury or paralysis, migration of the implant, osteophytosis, split fracture of the vertebral body.

Last generations discs is easy to install that shorten operation time.

Both treatments are usually effective for relieving pain. However, preserving motion at the treated vertebral segment may enable the spine to restore its sagittal balance and maintain more natural mechanics after surgery than fusing the vertebral segment. This may potentially decelerate degeneration in healthy adjacent levels in the spine.

The advantages of the artificial cervical disc over a fusion include: maintaining normal neck motion, reducing degeneration of adjacent segments of the cervical spine, kyphosis correction, absorb some of the daily stresses of the neck, eliminating the need for a bone graft, early postoperative neck motion, faster return to normal activity.

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