416 - Cervical Arthroplasty

Cervical Arthroplasty L E A R N I N G O B J E C T I V E S s Examine the role of the Certified Surgical Technologist during a cervical disc replacement procedure s Compare and contrast between cervical disc arthroplasty and anterior cervical discectomy and fusion s List the contraindications for performing a CDR s Review the anatomy and pathophysiology discussed in this article s Recall the equipment and supplies needed for a cervical disc replacement El ia V Smalls , cst, and Jaime Chi luisa, cst C ervical artificial disc replacement or cervical disc arthroplas- ty is a joint replacement procedure that removes the natural intervertebral disc and inserts an implant in its place. These procedures represent a relatively new area in spinal surgery for degen- erative cervical disease with the first cervical disc arthroplasty being was performed in the United States only 10 years ago in 2008. The cervical artificial disc is designed to maintain the natural movement of the cervical spine while avoiding stress on adjacent levels in the spine, which can occur with a traditional ACDF. H I S T O R Y O F C E R V I C A L D I S C A R T H R O P L A S T Y Cervical disc replacement implants originated in Europe in the mid- 1960s. In 1966, Ulf Fernstrom was credited with implanting the first cervical and lumbar disc replacement devices. The original implant For decades, anterior cervical discectomy and fusion (ACDF) has been the golden standard in treating cervical spine disease. An ACDF requires that the surgeon completely remove the intervertebral disc of the affected level, insert a cortical-cancellous allograft in the intervertebral space and secure it with a plate and screws that are implanted into the adjacent vertebral bodies. Although ACDF has demonstrated positive outcomes, concern remains about adjacent segment disease (ASD). In recent years, cervical disc replacement (CDR) has become an alternative to ACDF when treating disease of the cervical spine to maintain the patient’s range of motion (ROM) while avoiding ASD. AUGUST 2018 | The Surgical Technologist | 351