Abstract
Background Cervical arthroplasty with artificial cervical disks has gained popularity as an
alternative to anterior discectomy and fusion. The main advantages of disk arthroplasty
include maintenance of the range of movement, restitution of disk height and spinal
alignment, and reduction of adjacent segment degeneration (ASD). In this article,
we aimed to assess the outcomes of the use of a keel-less prosthesis.
Material and Methods We included all the patients who underwent single-level cervical arthroplasties with
the Discocerv Cervidisc Evolution for “soft” disk herniation. Clinical assessment
included Neck Disability Index (NDI) and visual analog scale (VAS) for neck and arm
pain. Radiologic studies investigated the occurrence of ASD and system failure or
subsidence. The reoperation rate was also recorded.
Results The study included 35 patients (14 men and 21 women; mean age: 42.5 years; mean follow-up:
57.8 months). There was a significant decrease in VAS neck and VAS arm scores, which
went from 7.2 and 6.9 preoperatively to 2.2 and 1.7 postoperatively, 2.2 and 1.6 at
6 months, 2.0 and 1.8 at 1 year, and 2.1 and 1.3 at the last follow-up, respectively.
The mean NDI score was 58.0 preoperatively, 19.4 postoperatively, 17.0 at 6 months,
16.1 at 1 year, and 16.2 at the last follow-up. Radiologic studies revealed a preserved
range of motion in 33 of 35 patients. No ASD occurred and no reoperation was required.
Conclusions Cervical disk arthroplasty with a keel-less prosthesis can be a safe and effective
alternative to fusion for degenerative disk disease in selected patients, with a possible
reduction of ASD.
Keywords Discocerv - cervical arthroplasty - disk prosthesis - disk replacement - cervical
herniation
