Background Image
Previous Page  5 / 20 Next Page
Basic version Information
Show Menu
Previous Page 5 / 20 Next Page
Page Background

Why is artificial disc technology

the future?

Techniques continually advance and rigid

fusion after discectomy in the cervical

spine itself may cause further problems.

By immobilising a previously dynamic

structure, fusion causes an increase in

Intradiscal Pressures (IDPs), intersegmental

motion and facet joint stresses above

and below the fusion.This may cause the

development of accelerated degeneration

at other disc levels. Studies quote varying

degrees of Adjacent Level Spondylosis

(ALS) after cervical fusion, between 9-32%

at a mean of 7 years after surgery, or 26%

of patients developing symptomatic ALS

10 years later. In contrast, implantation of

an artificial cervical disc has been shown

to preserve adjacent IDPs and operative

level kinematics. The disc prosthesis

is engineered to preserve range of

movements. By preserving motion in the

cervical spine and helping to prevent ALS,

disc arthoplasty may have the additional

benefit of reducing the symptoms of neck

pain that may be unchanged after fusion

operations.

Surgical technique and results

Relief of nerve root compression and/or

spinal cord compression still relies upon

expert and meticulous neurosurgical

technique. However, the insertion of

the disc prosthesis requires new training

and techniques.The disc space must be

prepared precisely to fit the shape and

size of the suitable disc prosthesis. Most

patients stay in hospital for only two or

three nights.

In our series of over 60 cases of cervical

disc replacement, more than 95% of

patients have improvement or resolution

of symptoms. In addition, there has been

encouraging improvement in neck pain

symptoms indicating possible additional

advantages of the disc replacement over

fusion surgery.

Conclusions

Cervical disc arthroplasty with the

artificial disc system after anterior

cervical discectomy offers the ability to

preserve physiological spinal dynamics

and to prevent the future development

of adjacent level degenerative changes.

For the patient, this may mean better

long-term outcomes without the need

for further complex surgery and the

possibility of improvement of the neck

pain symptoms in comparison with rigid

fusion techniques. Cervical fusion might

become an outdated concept, with the

realisation of preserving cervical spinal

motion and function.

Spine Treatment

FIVE

Spine Treatment

Mr Habib Ellamushi is a Consultant Neurosurgeon at London

Bridge Hospital and St Bartholomew’s and the Royal London

Hospitals and Honorary Senior Lecturer at the Queen Mary’s

Medical College, University of London.

Mr Ellamushi had higher specialist training in Neurosurgery in

the National Hospital, Queen Square, Charing Cross Hospital

and Great Ormond Street. He completed his research into

Neuroimaging of brain tumours, cerebral aneurysms and

epilepsy. He furthered his neurosurgery subspecialty training

in the USA, Canada and France. He leads multidisciplinary

teams in minimal access spinal surgery, craniofacial surgery

and neurostimulation.

Mr Ellamushi’s neurosurgery practice includes cranial and

spinal neurosurgery with particular interest in minimal

access (keyhole) spinal surgery, brain and spinal tumours,

Gamma Knife and CyberKnife Stereotactic Radiosurgery

and Neurostimulation.

CONTACT:

T 07908 668067 M 07833 453949

F 01277 363524 E

[email protected]

Figure 1

Sagittal MRI of the cervical spine showing a large disc

degenerative prolapse at the C5/6 level, causing severe

spinal cord compression.

Figure 2

A&B:The cervical disc prosthesis.

C: Lateral postoperative X-ray showing the disc

prosthesis.

Mr Habib Ellamushi

MB ChB FRCS(Ed) FRCS(SN)