An Alternative to Anterior Cervical Discectomy and Fusion (ACDF)
Indications:
Cervical Spondylotic Radiculopathy and or Myelopathy
Average 1.5 year follow up:
20 Prestige LP cervical disc arthroplasties
Analysis of Results:
Scoring
Biomechanics
Radiological Analysis
Subsidence and maintenance of decompression
Motion Preservation
Heterotopic Ossification
Analysis of Complications
Adjacent Segment Disease Literature- controversial still?
Hilibrand et al.:
2.9% patients each year with ACDF require additional surgery due to adjacent level problems
25% prevalence of new symptomatic disease at a level adjacent to a prior fusion within 10 years.
Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. HH. J Bone Joint Surg Am. 1999 Apr;81(4):519-28.
ILLUSTRATIVE CASE STUDIES
Cervical Myelopathy from Cervical Disc Prolapse
Female mid twenties
Train Driver
Upper limb numbness since 2003
Deterioration with difficulty to hold pen or chopstick since June 2006
JOA score 15/17