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Article Reviews Technique for Cervical Disc Arthroplasty

Key points include neutral neck position, proper end plate preparation, correct prosthesis size

MONDAY, Oct. 19 (HealthDay News) -- Cervical disc arthroplasty -- which research has suggested is equivalent to arthrodesis for cervical myelopathy with single-level abnormalities in the disc space -- is the focus of a surgical technique article in a supplement to the Oct. 1 issue of the Journal of Bone & Joint Surgery.

Jacob M. Buchowski, M.D., of Washington University in St. Louis, and colleagues follow a 2008 study on cervical disc arthroplasty with a review on performing the procedure, focusing on a standard method for decompressing the disc space, given that different systems have different requirements.

The authors note that positioning the neck in a neutral manner at the outset is crucial for preventing the prosthesis from resting in a kyphotic or lordotic position. When preparing the end plates, care must be taken to avoid excessive resection, as most of the end plate needs to be preserved; however, different systems have their own requirements for end plate removal. The properly sized prosthesis will be neither too loose nor too tight; 5 to 6 millimeters in height is usually appropriate.

The chief disadvantage of anterior cervical discectomy and fusion is "the loss of motion segments, which may accelerate adjacent disc degeneration," Buchowski and colleagues write. "Conversely, cervical disc arthroplasty in the correctly-selected patient can potentially reduce the risk of adjacent-segment degeneration by relieving neural compression, restoring intervertebral height and spinal alignment, and preserving motion."

At least one author reported a financial relationship with Medtronic.

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