Cervical Artificial Disc Replacement is a technology designed to replace a symptomatic cervical degenerated disc with a metal and plastic ball and socket prosthesis. A symptomatic disc is defined as causing neck (axial) or arm (radicular) pain with or without a functional or neurologic deficit. Examples of structurally degenerated discs are herniated nucleus pulposes (your classic ‘herniated disc’), spondylosis (evidenced by the presence of bone spurs (osteophytes)), and loss of disc height or hydration of the disc (like a sponge drying out).
The C-ADR is inserted from a front side (anterior) approach. It is implanted at the diseased level after the disc has been completely removed (total discectomy). The discectomy and removal of bone spurs will decompress the nerves and spinal cord. The implanted C-ADR will maintain the joint space height and potentially preserve motion at the surgical level. This motion preservation may theoretically prevent or slow the progression of adjacent disc levels from degenerating.
This is a case of a 47 year-old female with excruciating neck and right arm pain and weakness. The pain radiated down to her thumb. She had an MRI that demonstrated a degenerated disc at C5-6 with loss of disc height and a broad based disc herniation. She had failed a 6 month course of non-surgical management in the form of medications, injections, and physical therapy. She ultimately underwent a C-ADR at C5-6 with immediate relief of her neck and arm pain.
Figure 1 demonstrates a lateral X-ray with the implant in place.