Primary and Revision Cervical Disc Arthroplasty from 2010–2020: Patient Demographics, Utilization Trends, and Health Care Reimbursements

Study Design: Narrative review. Objectives: The purpose of this study was to provide a review of the current evidence on the impact of posterior cervical foraminotomy (PCF) performed before or after cervical disk replacement (CDR). Summary of Background Data: The impact of PCF on outcomes in the setting of CDR is an evolving field, given the recent widespread adoption of CDR and the relative rarity of patients who have undergone both procedures. Methods: A literature search was conducted using PubMed to determine current evidence regarding the indications, outcomes, and biomechanical effects of CDR and PCF when performed alone or in combination. Results: When radicular symptoms persist following PCF, a CDR can be safely performed to provide further decompression. Conversely, a PCF can be safely performed following CDR for these same indications. The biomechanical effects of these procedures in combination demonstrate maintained stability when the facetectomy is less than 50% of the facet joint. Studies demonstrate that stability is not significantly decreased by the presence, amount, or level of posterior foraminotomies in the setting of CDR. Conclusions: A PCF can be safely performed before or after cervical disk arthroplasty for recurrent radicular symptoms. Level of Evidence: Level V.

Section: Utilization Of Pcf For Persistent/ Recurrent Symptoms After Cdrmentioning

confidence: 99%

Section: Utilization Of Pcf For Persistent/recurrent Symptoms After Cdrmentioning

confidence: 99%

Impact of Posterior Cervical Foraminotomy Before or After Cervical Disk Replacement

Young,

Abtahi

2023

“…Length of stay was also significantly higher (1.37 vs 3.30 d, P < 0.001) in the revision group. 11 In a 2021 systematic review, a 5-year index-level revision rate of 3.9% (n = 170) for CDA was reported, with a small percentage of these undergoing multiple revisions (n = 9). 14 The most common secondary procedures were ACDF (68%) and posterior cervical fusion (15.5%).…”

Section: Literature Reviewmentioning

confidence: 99%

Revision Strategies for Cervical Disc Arthroplasty

Roth,

Robles Ortiz,

Vulapalli

et al. 2023

Study Design: Narrative review. Objective: To review indications and strategies for revision of cervical disc arthroplasty (CDA). Summary of Background Data: No data were generated as part of this review. Methods: A narrative review of the literature was performed. Results: No results were generated as part of this review. Conclusions: CDA is a proven, motion-sparing surgical option for the treatment of myelopathy or radiculopathy secondary to cervical degenerative disc disease. As is the case with any operation, a small percentage of CDA will require revision, which can be a technically demanding endeavor. Here we review available revision strategies and associated indications, a thorough understanding of which will aid the surgeon in finely tailoring their approach to varying presentations.

“…Since the early 2000s, cervical disc arthroplasty (CDA) has gained significant momentum, with the ability to address stenosis while preserving the range of motion 4,5 . The acceptance and use of these devices have increased significantly over the past decade 6 . With the increased adoption of CDA, there has been a significant expansion of device options in the market, designed with a variety of materials, articulations, and geometries 7,8 …”

mentioning

confidence: 99%

“…4,5 The acceptance and use of these devices have increased significantly over the past decade. 6 With the increased adoption of CDA, there has been a significant expansion of device options in the market, designed with a variety of materials, articulations, and geometries. 7,8 WHAT WE KNOW…”

mentioning

confidence: 99%

Past, Present, and Future of Cervical Disc Arthroplasty

Du,

Gonzalez,

Albert

et al. 2023

T he cervical spine is a sophisticated biomechanical structure that provides for mobility while maintaining horizontal gaze. Unfortunately, due to pathology such as degeneration, trauma, and infection, there is a significant disease burden of the cervical spine resulting in conditions such as radiculopathy and myelopathy. 1,2 In the degenerative population, cervical spine surgery is an option for patients who have exhausted nonoperative management efforts or have progressive neurologic deficits. Over the last century, anterior cervical discectomy and fusion (ACDF) has been shown to be an effective operation for pathologic conditions due to the ability to decompress the neural elements and stabilize the spine at the surgical site. 3 This is following the natural history of cervical degener-