The Use of Artificial Disc Replacement in Degenerative Conditions of the Cervical Spine

Purpose of Review Anterior cervical fusion, the gold standard for reconstruction following anterior cervical decompression, is both safe and effective but potentially accelerates degeneration of adjacent segments. Artificial disk replacement is an emerging technology with the potential to maintain motion and decrease adjacent segment degeneration. Several devices are currently in pilot studies with early and intermediate results reported.This article reviews the current clinical and basic science studies evaluating the Frenchay and Bryan artificial cervical disk replacement devices. Recent Findings Current clinical studies of the Frenchay and Bryan devices have exceeded targeted success rates at six months, one year and two years. Both devices allow maintenance of physiologic motion at the implanted level without increasing motion at adjacent segments.Wear analysis of the Bryan Disc shows a low wear rate and satisfactory biologic response with minimal inflammatory reaction. Summary Early clinical results of disk replacement are comparable to anterior fusion in the same follow-up period. Biomechanical studies indicate that disk replacement does minimize stress at adjacent levels while maintaining normal physiologic segmental motion in the whole cervical spine.Wear analysis supports low wear rates with minimal inflammatory response. Only long-term follow-up will prove if cervical disk replacement is equal or superior to anterior cervical fusion.