Expanding Indications for Cervical Artificial Disc Replacement
The indications for cervical artificial disc replacement are expanding. Based on a number of recent clinical research trials, the benefits of cervical disc replacement are becoming more apparent, not only for treating patients with single level disc herniation, but also for patients suffering pinched nerves from herniated discs at two levels, and patients with spinal cord dysfunction due to herniated discs. Until recently, patients with these conditions were managed with spinal fusion which may have detrimental effects on the remaining discs over time.
Jeff McConnell, MD, was honored by the invitation to present information on cervical artificial disc replacement at the November, 2017 Cervical Spine Research Society meeting in Hollywood, Florida. During this prestigious scientific forum, Dr. McConnell presented 2 studies based on the results of the landmark two-level Prestige-LP cervical artificial disc IDE clinical trial:
- “Long-term Outcomes of Arthroplasty for Cervical Myelopathy versus Radiculopathy, And Arthroplasty versus Arthrodesis for Cervical Myelopathy”
- The results of this study challenge the traditional recommendation of spinal fusion to treat patients with cervical myelopathy (spinal cord dysfunction) due to herniated discs.
- Patients with myelopathy treated with disc replacement at two levels did just as well as those treated with fusion.
- Patients with myelopathy demonstrated similar rates of clinical success as patients with radiculopathy when treated with two-level disc replacement.
- “Comparison of the Long Term Results of One-Level vs Two-level Cervical Total Disc Replacement and Anterior Cervical Discectomy and Fusion”
- Although patients with herniated discs at two-levels in the cervical spine have twice the problem, and require more surgery to correct, they do equally as well as patients treated with artificial disc replacement at one level.
- Patients who received cervical fusion had higher reoperation rates at the operated levels and adjacent disc levels.
The information presented by Dr McConnell and his coauthors adds to the growing body of clinical evidence that cervical artificial disc replacement, at one and two levels, is safe and effective for treating a number of conditions due to cervical disc disease.