What is it about?
Artificial disc replacement is an alternative therapy for patients who have already undergone cervical fusion and have developed new disc degeneration in adjacent levels.
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Why is it important?
At present, patients who have already had cervical fusion previously and having fresh symptoms in the adjacent levels are considered for additional fusion at these levels. This leads to loss of motion and added stress at other levels, probably worsening disc degeneration. Instead of fusion, artificial disc replacement will preserve motion in these levels, hoping to reduce the stress at other levels.
Perspectives
Natural fusion of cervical discs occur at a late stage of the disease process and nature tries to preserve the disc motion till the last. Artificial disc replacement tries to imitate this in preserving this motion. Multi- level disc fusion is considered in certain situations and artificial disc replacement appears to be an attractive option in such situations, though specific data needs to accumulated to prove this. Interestingly, this article provides data that segmental motion at the artificial disc replacement level is actually better than pre-operative motion. If validated in multiple studies, then there needs to be a re-look at fusion as a primary procedure.
Dr Vasudeva Rao Rajakumar Deshpande
Fortis Hospitals
Read the Original
This page is a summary of: Adjacent-level arthroplasty following cervical fusion, Neurosurgical FOCUS, February 2017, Journal of Neurosurgery Publishing Group (JNSPG),
DOI: 10.3171/2016.11.focus16412.
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