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Artificial Cervical

Disc Replacement

Approximately half of the population

over 50 years of age will show changes

of degenerative changes in the cervical

spine. 20% of these patients will

develop symptoms such as neck pain or

discomfort and a ‘clicking’ noise upon neck

movements. Nerve root compression

causes pain radiating into the arm and

the hand (Brachialgia) and/or altered

sensation (numbness) and/or motor

weakness. Compression of the spinal

cord causes Myelopathy, with progressive

weakness and spasticity of the arms and

legs, difficulty with fine motor function

of the hands, unsteady gait and poor

balance. MRI of the cervical spine is the

investigation of choice to demonstrate the

anatomy of the vertebral column, discs,

spinal cord and nerve roots. Confirmation

of nerve root dysfunction may be clarified

with an EMG test.

Traditionally, neurosurgeons have

replaced the resected disc with bone

graft or cages to achieve fusion and

stability. However, new technology is being

pioneered which avoids the potential

problems caused by unphysiological

fusion. Disc replacement restores the

biomechanical movements of the spinal

segment using artificial disc implantation.

Neurosurgical management

Almost 70-80% of patients with

cervical nerve root compression usually

settle spontaneously with conservative

Mr Habib Ellamushi

MB ChB FRCS(Ed) FRCS(SN)

Consultant Neurosurgeon

New technology

in the Treatment

of Cervical

Degenerative Disc

measures, such as physiotherapy,

analgesics, acupuncture etc.

Failure of symptoms to improve

(persisting symptoms) or recurrent

symptoms, requires referral to a

neurosurgeon. In most cases, anterior

compression of nerve roots and/or

the spinal cord necessitates surgery

via an anterior approach, using a right-

sided transverse cervical incision, with

microscopic removal of the intervertebral

disc(s) and posterior bony osteophytes.

It is traditional for the resulting interspace

to be ‘fused’ using techniques such as an

iliac crest, synthetic bone graft or cage

system with or without anterior cervical

plate and screws.

Spine Treatment

Spine Treatment

FOUR

The mobile cervical spine is particularly prone to degenerative change. Degenerative

Cervical Spondylosis is a common disorder in late middle age and may cause spinal

cord or nerve root compression, resulting in a variety of neurological symptoms.