Cervical Disc Arthroplasty (Artificial Disc)
Cervical disc arthroplasty is a spinal surgery in which a damaged intervertebral disc in the neck is removed and replaced with a motion-preserving artificial disc. The aim is to relieve disc pathology compressing a nerve root or the spinal cord while maintaining motion at the treated level as far as possible, offering an alternative to fusion.
Përditësimi i fundit: 2026-06-09
Definition
Cervical disc arthroplasty is the removal of a worn or herniated disc in the neck through an anterior approach and its replacement with an artificial disc implant that permits joint motion. It shares the same decompression goal as cervical fusion (ACDF); however, instead of fusing the adjacent levels, it aims to preserve movements such as flexion, extension, and rotation at the treated level. As a motion-preserving technique, it is considered as an option to fusion in selected patient groups.
Indications
Cervical disc arthroplasty is considered, usually at one or two levels, in cases of radiculopathy or selected myelopathy from a disc herniation or disc degeneration demonstrated on imaging (MRI) and concordant with clinical findings. Candidates are typically patients who have not responded to an adequate trial of conservative treatment and who lack marked facet arthrosis, advanced instability, severe osteoporosis, or extensive posterior osteophytes/ossification. The indication relies on the symptoms matching the anatomical pathology of the level and on a spinal anatomy suited to motion preservation.
Procedure
The procedure is usually performed under general anesthesia with the patient supine. A small incision on the front of the neck provides access through the soft tissues to the anterior surface of the spine. After the target level is confirmed with fluoroscopy, the disc space is cleared; disc material and, when needed, osteophytes compressing the nerve root or spinal cord are removed to achieve decompression. An appropriately sized artificial disc is then placed between the endplates and its position is checked with imaging. After hemostasis is achieved, the layers are closed.
Advantages and Limitations
The main theoretical advantage of disc arthroplasty is that, by preserving motion at the treated level, it aims to reduce the mechanical load transferred to adjacent levels and the associated degeneration; randomized trials have reported outcomes similar to or competitive with fusion in suitable patients. However, the prosthesis is not appropriate for every patient; it may not be preferred in marked instability, advanced facet arthrosis, severe osteoporosis, or extensive multilevel pathology. Heterotopic ossification, loss of implant motion over time, and uncertainty about long-term durability are among the limitations. The technique requires experience and careful patient selection.
Recovery and Risks
Recovery time varies by patient; many patients mobilize relatively early and return gradually to daily activities. Possible risks include infection, bleeding, difficulty swallowing or hoarseness, dural tear and cerebrospinal fluid leak, nerve or spinal cord injury, implant migration, heterotopic ossification, and adjacent-level problems. Symptoms may not resolve completely, or additional intervention may become necessary over time. No outcome is guaranteed; the decision is individualized by considering the patient's clinical status, imaging findings, and expectations together.
Burimet
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- National Institute for Health and Care Excellence (NICE). Prosthetic intervertebral disc replacement in the cervical spine. Interventional procedures guidance.
Ky artikull ka karakter të përgjithshëm informues dhe nuk zëvendëson vizitën mjekësore. Vendimet për diagnozën dhe trajtimin janë individuale.