Total disc arthroplasty and anterior cervical discectomy and fusion in cervical spine: competitive or complimentary? Review of the literature

Global Spine Journal
Ajay Jawahar, Pierce Nunley

Abstract

Anterior cervical discectomy and arthrodesis has come to represent standard of care for patients with persistent radicular and/or myelopathic symptoms that have failed to improve with conservative treatments. One potential complication of the procedure is the accelerated degeneration of the vertebrae and the intervertebral discs adjacent to the level fused and the effects of fusion on those levels. The concern that fusion may be a contributing factor to accelerated adjacent segment degeneration led to increased interest in cervical disc replacement after anterior decompressive surgery. Several studies analyzing the short-term outcomes of the disc replacement procedure have been published since then, and the pros and cons of both procedures continue to remain a topic of debate among the scientific community. The analysis of published literature and our own experience has convinced us that the overall longer-term clinical outcomes after anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR) in the general patient population are not significantly different in terms of symptomatic improvement, neurological improvement, and restoration to better quality of life. Age of the patients and number of affected lev...Continue Reading

References

May 4, 1999·The Journal of Bone and Joint Surgery. American Volume·A S HilibrandH H Bohlman
Jul 21, 2004·Journal of Spinal Disorders & Techniques·Jan GoffinJohan van Loon
Nov 16, 2004·The Spine Journal : Official Journal of the North American Spine Society·Paul C McAfee
Nov 16, 2004·The Spine Journal : Official Journal of the North American Spine Society·Alan S Hilibrand, Matthew Robbins
Jun 20, 2007·The Journal of Bone and Joint Surgery. American Volume·Raj D RaoJason C Eck
Nov 4, 2008·The Journal of Bone and Joint Surgery. American Volume·K Daniel RiewPaul A Anderson
Oct 12, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Ingrid ZechmeisterPhilipp Mad
Feb 22, 2011·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·J HuppertL Aubourg
Jul 22, 2011·The Journal of Bone and Joint Surgery. American Volume·Ben J GarridoRick C Sasso
Oct 19, 2011·The Spine Journal : Official Journal of the North American Spine Society·Ajay Jawahar, Pierce D Nunley

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Citations

Sep 17, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kristopher M LundineGerald Quan
Jun 25, 2016·Asian Spine Journal·Jae Yoon ChungSung Kyu Kim
Apr 24, 2015·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jing Tao ZhangYong Shen

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Methods Mentioned

BETA
total disc arthroplasty

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