Review of long-term outcomes of disc arthroplasty for symptomatic single level cervical degenerative disc disease

ABSTRACT

Introduction: Cervical disc arthroplasty (CDA) was developed as an alternative for anterior cervical discectomy and fusion (ACDF) for nerve root decompression. The rationale behind CDA was to help prevent adjacent segment degeneration which potentially may lead to additional surgery. Multiple randomized controlled trials have evaluated a myriad of disc arthroplasty devices over the past 10 years and provided data regarding clinical benefits and safety. Their long-term data, reporting results at 5–10 years, presents the opportunity to comment on the overall efficacy, safety and reported complications of these devices. This report reviews results of the Prestige, proDisc-C, Mobi-C Disc and various other arthroplasty devices and provides an overall report of the longest term available data and comparisons between devices.

Areas covered: This review summarizes previously published articles in a literature search using keywords: ‘cervical disc arthroplasty’, ‘cervical total disc replacement’, ‘anterior cervical decompression and fusion’, ‘anterior cervical arthrodesis’, ‘symptomatic degenerative disc disease’ and commercial names of devices.

Expert commentary: CDA, with the devices reviewed, resulted in favorable outcomes in comparison to ACDF for the treatment of symptomatic cervical degenerative disc disease (DDD) taking in to account the long-term functional recovery, adverse events, development of adjacent segment degeneration and subsequent surgical interventions.

KEYWORDS:

• Anterior cervical arthrodesis
• anterior cervical decompression and fusion (ACDF)
• cervical disc arthroplasty (CDA)
• cervical total disc replacement
• symptomatic degenerative disc disease (DDD)

Declaration of interest

PD Nunley has the following potential conflicts of interest: ABSS (Board or Committee Member); Amedica (Stock or stock options); K2M, Inc.(IP royalties, paid consultant, paid presenter or speaker); LDR (Paid presenter or speaker); LDR Spine (I P royalties); Paradigm Spine (Stock or stock opitions); Spineology (Stock or stock options). WF Lavelle has the following potential conflicts of interest: DePuy, Medtronic, IntegraLife, Sigmus, Inc., K2M Inc., Providence Technologies, Stryker Spine, Vertebral Technologies, Inc. (Grants paid to institution); Stryker Spine (Speaker). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This article is not funded.