Cervical Disc Replacement Update (Research Article)

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1、CervicalDiscReplacementUpdate(ResearchArticle)By:JeffreyA.Goldstein,MDandAlokD.SharantThecervicalintervertebraldiscisanamazingmechanicalstructurefromanengineeringperspective.Ithastheabilitytoabsorbalargecompressiveloadwhilestillprovidingadequatemotionbetweentwoadjacentbonyvertebr

2、ae.Duplicatingthedisc’sformandfunctionwithasyntheticdiscischallenging.However,severalcervicalartificialdiscsareinvariousphasesofdevelopmentandtestingintheUSandmaysoonbeavailableforuseinthegeneralpatientpopulation.Thefirstreportofacervicaldiscreplacementinthemedicalliteraturecamef

3、romtheSouthAfricanMedicalJournalin1964.1Sincethentherehasbeengreatprogressintheresearchandthetechnologyofthecervicaldiscarthroplastyfield.Inadditiontherehasbeengreatprogressmadeinunderstandingthediseaseprocessthatcanresultintheneedforadiscreplacement.Thisreviewwilldiscussdegenera

4、tivediscdiseaseofthecervicalspineanditsresultantclinicalconsequences.Nextthecurrent“goldstandardtreatment”(fusion)willbediscussedincludingtherationalefortheuseofadiscreplacement.Finallythedifferenttypesofcervicaldiscreplacementtechnologieswillbedescribed.CervicalDegenerativeDiscD

5、iseaseCervicaldegenerativediscdiseaseofthespineisaprevalentconditioninthepopulation.Studieshaveshownthatafterage40,almost60%ofthepopulationhasradiographicevidenceofcervicalspinedegenerationandbyage65,95%ofmenand70%ofwomenwillhavesomesortofdegenerativechangeonx-ray.2Fortunately,ma

6、nyofthesechangesseenonx-raycanbeconsideredageneralagingphenomenonandnotpathologicalasmostpeoplewithdegenerativechangesonanimagingstudydonothaveanypainorothersymptoms.However,insomepatients,asthediscdegeneratesitcanresultinageneralarthritisofthebonyelementsofthecervicalspineoraher

7、niationofthediscelements.Oneoftheclinicalmanifestationsofdiscdegenerationcanresultinneckandradiculartypeofarmpain(painthatradiatesfromtheneckdownthearmandpossiblyintothehandandfingers).Inadditiontoneckpainand/orarmpain,symptomsmayincludenumbness,tinglingorweakness,andagainthesesy

8、mptomsmayradiateintothearm.InThisArticle