The Bryan Artificial Disc

p0020The cervical spine is a linkage of specialized joints and, like other joints, may be the source of significant pain and functional incapacity with age, trauma, and subsequent degeneration. However unlike other major joints, the traditional perception is that motion in the cervical spine is not a necessity and has been routinely sacrificed for pain relief and functional recovery. For more than 50 years, anterior cervical discectomy and fusion (ACDF) has been the treatment of choice for cervical disc disease. Numerous studies have demonstrated the kinematic and biomechanical limitations inherent in this procedure in addition to the potential to accelerate adjacent segment degeneration. Thus, intervertebral disc replacement has been designed to remedy these shortcomings. Duggal et al confirmed preservation of motion in Bryan disc replacement–treated spinal segments with a mean range of motion of 7.8 degrees at 24 months. Sasso et al described normal flexion/ extension motion (6.7 degrees) in comparison to ACDF of 0.6 degrees at 24 months postoperatively. In addition, abnormal motion at the adjacent segment of a fusion was demonstrated. An increase in anterior or posterior translation at the cephalad adjacent level in patients with arthrodesis occurred while the Bryan arthroplasty retained normal translation for the same amount of flexion/extension at the adjacent level. s0020 INDICATIONS/CONTRAINDICATIONS