The article discusses cervical disc arthroplasty (CDA) as an alternative to anterior cervical discectomy and fusion for disc problems. Previous clinical trials of CDA have focused on one- or two-level disc herniation at C3-7, but there is uncertainty about its effectiveness for C2-3 disc herniation. The article presents a case study of a patient with refractory symptoms and herniated discs at C2-3, C3-4, and C4-5. The patient underwent anterior discectomies with artificial disc replacement at each level, which successfully relieved his symptoms. This is the first reported case of CDA at C2-3, suggesting it may be a viable option for cervical disc disease
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated treatment hospital in UK
Published article
BACKGROUND: Since the beginning of the 21st century, cervical disc arthroplasty (CDA) has been accepted as an alternative to anterior cervical discectomy and fusion for surgical management of disc problems. The published clinical trials of CDA have included patients with radiculopathy or myelopathy caused by one- or two-level disc herniation at C3-7. However, it remains uncertain whether CDA is a viable option for C2-3 disc herniation.
Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Since the beginning of the 21st century, cervical disc arthroplasty (CDA) has been accepted as an alternative to anterior cervical discectomy and fusion for surgical management of disc problems. The published clinical trials of CDA have included patients with radiculopathy or myelopathy caused by one- or two-level disc herniation at C3-7. However, it,
Abstract
Background: Since the beginning of the 21st century, cervical disc arthroplasty (CDA) has been accepted as an alternative to anterior cervical discectomy and fusion for surgical management of disc problems. The published clinical trials of CDA have included patients with radiculopathy or myelopathy caused by one- or two-level disc herniation at C3-7. However, it remains uncertain whether CDA is a viable option for C2-3 disc herniation.
Observations: In this report, a 52-year-old man presented with hand numbness, arm pain, and myelopathic symptoms that were refractory to medical treatment for more than 6 months. The magnetic resonance images demonstrated herniated discs at C2-3, C3-4, and C4-5, causing stenosis. There was no ossification of posterior longitudinal ligament and the spine was mobile, so he received anterior discectomies with artificial disc replacement at each of the C2-3, C3-4, and C4-5 levels. The surgery went smoothly, and his neurological symptoms were promptly relieved. The postoperative radiographs at 24 months demonstrated a preserved range of motion at each level.
Lessons: To date, this was the first report of CDA performed at C2-3, which also involved three consecutive levels of disc replacement. The report suggested that both C2-3 and three-consecutive-level CDA may be a viable option for cervical disc disease.
Keywords: ACDF; C2–3; CDA; anterior cervical discectomy and fusion; artificial disc replacement; cervical disc arthroplasty; disc herniation; three consecutive level.
The London Spine Unit : best situated treatment hospital in UK
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Cervical disc arthroplasty at C2-3: illustrative case
