Cervical Total Disc Replacement

Callanan, Gregory; Radcliff, Kris

doi:10.1016/j.nec.2021.05.007

Cited by 13 publications

(21 citation statements)

References 48 publications

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“…ACDF is a common surgical treatment for CSM, owing to its good clinical therapeutic outcome [6,8]. Although ACDF can achieve interbody fusion, it may also lead to complications like pseudojoint, accelerated degeneration of adjacent segments, and loss of activity of fused segments [9][10][11][12]. Spine surgeons actively explore and improve their surgical methods to avoid these complications [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Transcorporeal decompression using a fully-endoscopic anterior cervical approach to treat cervical spondylotic myelopathy: surgical design and clinical application

Xin

Kong

et al. 2022

BMC Musculoskelet Disord

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Background Anterior cervical discectomy and fusion (ACDF) is a common procedure for treating cervical spondylotic myelopathy (CSM), however, ACDF may cause pseudoarthrosis, accelerated degeneration of adjacent segments, loss of activity of fused segments and other complications. The full-endoscopic technique can treat CSM, without the aforementioned complications above. Therefore, it is of great clinical value to investigate the surgical scheme of anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord (APFETDSC). Methods A total of 28 cases with single-segment Cervical spondylotic myelopathy (CSM) from April 2017 to July 2019 were involved in this study. The size of the disc-osteophyte complex was measured using imaging data prior to the operation. The diameter and direction of the bony passage was determined according to the size and central position of the complex, respectively. Twenty-eight patients underwent the above scheme for CSM. The clinical outcome evaluations included Visual Analog Scale (VAS) scores, Japanese Orthopedic Association (JOA) scores. The imaging assessment included MRI, CT and X-rays. Results The diameter of the designed bony passage was about 6.9 mm, and directed toward the lower edge of the diseased lower vertebral body oblique to the center of the disc-osteophyte complex. All patients successfully completed the operation. The postoperative neck pain VAS and JOA were significantly improved compared to preoperative values (p < 0.01). Postoperative MRI indicated complete decompression of the spinal cord. CT scanning 1 year after the operation revealed an almost healed bony passage and X-ray imaging showed satisfactory physiological curvature of the cervical spine, without cervical instability. Conclusion Based on the diameter and direction of the bony passage, as determined by the size and position of the disc-osteophyte complex, indicated by MRI and CT scanning, anterior percutaneous full-endoscopic transcorporeal decompression of the spinal cord offers good decompression of the spinal cord and ensures excellent therapeutic outcome.

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Section: Introductionmentioning

confidence: 99%

Transcorporeal decompression using a fully-endoscopic anterior cervical approach to treat cervical spondylotic myelopathy: surgical design and clinical application

Xin

Kong

et al. 2022

BMC Musculoskelet Disord

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“…The two endplates were made of cobalt, chromium, and 29 molybdenum ISO (International Organization for Standardization) 5832-12 alloy, and each line with teeth was on its outer edge. The internal contact surface of the inferior end plate is spherical, and the superior end plate is flat [49,55].…”

Section: Factors For Better Surgical Outcomesmentioning

confidence: 99%

“…It also prevents the core from leaving and protecting the facet from excessive loading [49,57] (Table 2).…”

Section: Factors For Better Surgical Outcomesmentioning

confidence: 99%

“…The indications for surgery approved by the FDA include level 1 or 2 segment cervical degenerative diseases or disc herniation and foraminal osteophytes that cause radiculopathy or myelopathy in adult patients [ 49 , 50 ]. Contraindications include osteoporosis or metabolic bone disease, active or prior infection, ankylosis, congenital cervical stenosis, facet arthritis, and segmental cervical instability.…”

Section: Cervical Disc Replacementmentioning

confidence: 99%

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Cervical Radiculopathy: Focus on Factors for Better Surgical Outcomes and Operative Techniques

2022

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For patients with cervical radiculopathy, most studies have recommended conservative treatment as the first-line treatment; however, when conventional treatment fails, surgery is considered. A better understanding of the prognosis of cervical radiculopathy is essential to provide accurate information to the patients. If the patients complain of persistent and recurrent arm pain/numbness not respond to conservative treatment, or exhibit neurologic deficits, surgery is performed using anterior or posterior approaches. Anterior cervical discectomy and fusion (ACDF) has historically been widely used and has proven to be safe and effective. To improve surgical outcomes of ACDF surgery, many studies have been conducted on types of spacers, size/height/position of cages, anterior plating, patients’ factors, surgical techniques, and so forth. Cervical disc replacement (CDR) is designed to reduce the incidence of adjacent segment disease during long-term follow-up by maintaining cervical spine motion postoperatively. Many studies on excellent indications for the CDR, proper type/size/shape/height of the implants, and surgical techniques were performed. Posterior cervical foraminotomy is a safe and effective surgical option to avoid complications associated with anterior approach and fusion surgery. Most recent literature demonstrated that all three surgical techniques for patients with cervical radiculopathy have clear advantages and disadvantages and reveal satisfactory surgical outcomes under a proper selection of patients and application of appropriate surgical methods. For this, it is important to fully understand the factors for better surgical outcomes and to adequately practice the operative techniques for patients with cervical radiculopathy.

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“…Cervical total disc arthroplasty is a safe and effective surgical alternative to arthrodesis in properly selected patients with cervical radiculopathy and myelopathy [ 69 ]. In carefully selected patients, lumbar disc replacement surgery has similarly been adopted as an alternative to fusion treatment for degenerative disc disease and may offer similar results to anterior-posterior fusion [ 70 ].…”

Section: Replacementmentioning

confidence: 99%

The Surgical Treatment of Osteoarthritis

Brumat

Kunšič

Novak

et al. 2022

Life

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Osteoarthritis is a degenerative condition affecting the whole joint with the underlying bone, representing a major source of pain, disability, and socioeconomic cost worldwide. Age is considered the strongest risk factor, albeit abnormal biomechanics, morphology, congenital abnormality, deformity, malalignment, limb-length discrepancy, lifestyle, and injury may further increase the risk of the development and progression of osteoarthritis as well. Pain and loss of function are the main clinical features that lead to treatment. Although early manifestations of osteoarthritis are amenable to lifestyle modification, adequate pain management, and physical therapy, disease advancement frequently requires surgical treatment. The symptomatic progression of osteoarthritis with radiographical confirmation can be addressed either with arthroscopic interventions, (joint) preservation techniques, or bone fusion procedures, whereas (joint) replacement is preferentially reserved for severe and end-stage disease. The surgical treatment aims at alleviating pain and disability while restoring native biomechanics. Miscellaneous surgical techniques for addressing osteoarthritis exist. Advanced computer-integrated surgical concepts allow for patient personalization and optimization of surgical treatment. The scope of this article is to present an overview of the fundamentals of conventional surgical treatment options for osteoarthritis of the human skeleton, with emphasis on arthroscopy, preservation, arthrodesis, and replacement. Contemporary computer-assisted orthopaedic surgery concepts are further elucidated.

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Cervical Total Disc Replacement

Cited by 13 publications

References 48 publications

Transcorporeal decompression using a fully-endoscopic anterior cervical approach to treat cervical spondylotic myelopathy: surgical design and clinical application

Transcorporeal decompression using a fully-endoscopic anterior cervical approach to treat cervical spondylotic myelopathy: surgical design and clinical application

Cervical Radiculopathy: Focus on Factors for Better Surgical Outcomes and Operative Techniques

The Surgical Treatment of Osteoarthritis

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