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Tsung-Hsi Tu, Chu-Yi Lee, Chao-Hung Kuo, Jau-Ching Wu, Hsuan-Kan Chang, Li-Yu Fay, Wen-Cheng Huang and Henrich Cheng

clinical trial: Clinical article . J Neurosurg Spine 21 : 516 – 528 , 2014 10.3171/2014.6.SPINE13996 25036218 3 Chang CC , Huang WC , Wu JC , Mummaneni PV : The option of motion preservation in cervical spondylosis: cervical disc arthroplasty update . Neurospine 15 : 296 – 305 , 2018 30545210 10.14245/ns.1836186.093 4 Chang HC , Tu TH , Chang HK , Wu JC , Fay LY , Chang PY , : Hybrid corpectomy and disc arthroplasty for cervical spondylotic myelopathy caused by ossification of posterior longitudinal ligament and disc herniation

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Tsung-Hsi Tu, Chao-Hung Kuo, Wen-Cheng Huang, Li-Yu Fay, Henrich Cheng and Jau-Ching Wu

A nterior cervical discectomy and fusion (ACDF) has been the standard surgical treatment for patients with cervical disc herniation or spondylosis causing intractable radiculopathy or myelopathy. Although symptom relief has been highly satisfactory after ACDF, there has also been adjacent-segment degeneration (ASD) that requires a secondary ACDF or other reoperation. 32 These cases of ASD may be attributable to increased load and compensatory motion after arthrodesis in ACDF. Cervical disc arthroplasty (CDA) was therefore designed to preserve segmental mobility

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Ali A. Baaj, Juan S. Uribe, Fernando L. Vale, Mark C. Preul and Neil R. Crawford

's results from a pilot study in which 82 cervical disc arthroplasties were implanted in 53 patients demonstrated significant improvements in the indices examined. There was 1 device migration that did not require revision surgery. An FDA IDE study is ongoing. In 2009, NuVasive (NuVasive, Inc.) acquired this device. The CerviCore Device The CerviCore device (Stryker Spine) is a semiconstrained, metal-on-metal prosthesis. The articulating surface is saddle-shaped ( Fig. 5 ), with 2 keels containing spikes present on each end plate. The saddle-shaped articulation is

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Anita Bhansali, Michael Musacchio and Noam Stadlan

I n recent years, cervical disc arthroplasty (CDA) has emerged as a popular alternative to anterior cervical discectomy and fusion (ACDF) for the surgical treatment of cervical degenerative disc disease. The essential advantage of CDA is the potential for reduction of the adjacent-segment degeneration encountered after ACDF. 6 , 9 This reduction in adjacent-segment degeneration is thought to be related to the ability of CDA devices to mimic normal spinal segmental motion, which may reduce the stress transfer to adjacent levels. 8 , 12 , 14 CDA has been well

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Timothy C. Chin-See-Chong, Pravesh S. Gadjradj, Robert J. Boelen and Biswadjiet S. Harhangi

of the neck. Abnormal loading stress on the adjacent levels due to fusion is hypothesized to cause ALD. 14 , 31 , 35 Another theory is that damage to the anterior longitudinal ligament or longus colli muscles during ACDF may cause ALD. 9 Artificial disc replacement, also known as total disc arthroplasty or cervical disc arthroplasty (CDA), is a less frequently performed technique to treat symptomatic CDH. During this procedure an artificial device is inserted between 2 vertebrae in the neck to replace the disc in the cervical spine. Several studies have already

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Matthew F. Gornet, J. Kenneth Burkus, Mark E. Shaffrey, Francine W. Schranck and Anne G. Copay

T he surgical technique for anterior cervical discectomy and fusion (ACDF) was first developed in the 1950s. 5 , 35 In the years that followed, ACDF became the gold standard of surgical treatments for specific cervical pathologies. Because of its long-standing use, ACDF limitations have been well described and its complications well documented, with outcomes reported beyond 10 years postoperatively. 2 , 16 In contrast, cervical disc arthroplasty (CDA) has been in use since the late 1990s 22 and is now considered an established alternative to ACDF for

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Bryan W. Cunningham, Nianbin Hu, Candace M. Zorn and Paul C. McAfee

is important to note that the data presented herein represent the acute fixation properties of various endplate designs and do not incorporate or reflect the long-term biological response of osseointegration. Using a synthetic vertebral model, the current study served to quantify the comparative acute fixation strengths and failure mechanisms of 6 cervical disc arthroplasty devices versus 2 conventional methods of cervical arthrodesis. The fundamental objective in this project was to highlight biomechanical advantages, if any, in variations of fixation properties

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Christopher Brenke, Johann Scharf, Kirsten Schmieder and Martin Barth

investigational site with a minimum 2-year follow-up. Clinical article . J Neurosurg Spine 13 : 715 – 721 , 2010 3 Cunningham BW , Hu N , Zorn CM , McAfee PC : Comparative fixation methods of cervical disc arthroplasty versus conventional methods of anterior cervical arthrodesis: serration, teeth, keels, or screws? Laboratory investigation . J Neurosurg Spine 12 : 214 – 220 , 2010 4 Heller JG , Sasso RC , Papadopoulos SM , Anderson PA , Fessler RG , Hacker RJ , : Comparison of BRYAN cervical disc arthroplasty with anterior cervical

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Tsung-Hsi Tu, Jau-Ching Wu, Henrich Cheng and Praveen V. Mummaneni

For patients with multilevel cervical stenosis at nonadjacent segments, one of the traditional approaches has included a multilevel fusion of the abnormal segments as well as the intervening normal segment. In this video we demonstrate an alternative treatment plan with tailored use of a combination of anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) with an intervening skipped level.

The authors present the case of a 72-year-old woman with myeloradiculopathy and a large disc herniation with facet joint degeneration at C3–4 and bulging disc at C5–6. After nonoperative treatment failed, she underwent a single-level ACDF at C3–4 and single-level arthroplasty at C5–6, which successfully relieved her symptoms. No intervention was performed at the normal intervening C4–5 segment. By using ACDF combined with arthroplasty, the authors have avoided a 3-level fusion for this patient and maintained the range of motion of 2 disc levels.

The video can be found here:

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David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Simon Mazas, Louis Boissière, Ibrahim Obeid, Vincent Pointillart, Jean-Marc Vital and Olivier Gille

, Cailliet R , Troyanovich SJ , Janik TJ , Holland B : Cobb method or Harrison posterior tangent method: which to choose for lateral cervical radiographic analysis . Spine (Phila Pa 1976) 25 : 2072 – 2078 , 2000 10.1097/00007632-200008150-00011 10954638 12 Heller JG , Sasso RC , Papadopoulos SM , Anderson PA , Fessler RG , Hacker RJ , : Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial . Spine (Phila Pa 1976) 34