Artificial Discs for the NeckEvery 10 years or so there's a giant leap forward in the world of spine surgery. The most recent leap ahead has been development of the artificial disc. This new treatment may be as important as the first joint replacements done years ago.
Researchers around the world are studying disc replacement. Some scientists are looking at its use in the the low back, or lumbar spine. Others are exploring its use in the neck, or cervical spine. In this study, an orthopedic surgeon used the artificial disc in seven patients. Each patient had pressure on the spinal cord in the neck from changes in the bone. This condition is called cervical spondylotic myelopathy.
In the past, doctors would work from the front of the spine to take pressure off the spinal cord. The procedure is called anterior decompression. In anterior decompression, the disc is removed, and the doctor puts traction on the neck to pull the space open further. The spine is then fused with bone graft and a metal plate and screws. This is called a strut graft fusion. Problems with this method of treatment led to the development of the artificial disc.
In this study, anterior decompression was still done first. Then one or more artificial discs were put in place. The author of this study reports good post-operative results. All seven patients showed improved arm and neck symptoms. Good neck range of motion was seen on imaging studies. Smokers in the group had the same good results as nonsmokers. For all patients, the disc height wasn't as high as when using a strut graft fusion.
The authors think cervical decompression with artificial discs may usher in a new era for care of the cervical spine. Long-term results will be reported as more research is done. The use of artificial discs for more than one level at a time will be explored next. For now, we know these devices can be used when there is pressure on the spinal cord in one or two levels of the neck.
Lali H. S. Sekhon. Cervical Arthroplasty in the Management of Spondylotic Myelopathy. In Journal of Spinal Disorders & Techniques. August 2003. Vol. 16. No. 4. Pp. 307-313.
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