Cervical Joint Replacement Shows Promise of Less Subsequent Surgery

Cervical degenerative disc disease is the wearing away of the pillow-like cushioning, or disc, between vertebrae in the neck. It can cause severe neck, shoulder and arm pain and loss of function that can greatly interfere with life. When conservative treatment, such as physical therapy or injections, fail surgery is indicated.

An anterior cervical discectomy and fusion (ACDF) is the traditional surgery of choice. This involves removing the problematic disc tissue and screwing the adjacent vertebrae together. While this often relieves the initial symptoms, it does frequently cause adjacent disc problems that lead to more pain and often require further ACDF surgery at other levels. A newer technique, called a total disc arthroplasty, removes all of the disc material and inserts an artificial disc, creating an artificial joint. This allows for continued movement at the involved segment.

A randomized clinical trial compared the outcomes of patients with an ACDF versus a total disc arthroplasty. Two hundred and nine patients were randomly treated with one type of surgery and then followed over a seven-year period. Authors followed the patient’s self-reported symptoms and functional levels, their arm and neck pain, further painful events, their self satisfaction with the surgery, and the number of follow up surgeries. They concluded that the total disc arthroplasty procedure is as safe and effective as the more standard fusion surgery. Both of the surgeries had very similar outcomes, with the exception that only 7 per cent of patients with the disc arthroplasty required subsequent surgery versus 18 per cent of patients with the fusion surgery.

References: Janssen, M., D.O., et al. ProDisc-C Total Disc Replacement Versus Anterior Cervical Discectomy and Fusion for Single-Level Symptomatic Cervical Disc Disease. The Journal of Bone and Joint Surgery. November 4, 2015. Vol. 97-A, No. 21. Pp. 1738-1747

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