416 - Cervical Arthroplasty

| The Surgical Technologist | AUGUST 2018 352 was a stainless-steel ball bearing prosthesis. Fernstrom implanted 191 lumbar spheres and 13 cervical spheres; however, these first cervical implants had unacceptable fail- ure rates. Interest in them faded until the 1980s and 1990s when their popularity and widespread use of lumbar arthro- plasty devices rose.¹ One of the first prototypes for the cer- vical spine was designed by BH Cummins in 1989. It was described as a two-piece, metal-on-metal device made of stainless steel. The articulating surface was a ball and socket design with two anterior anchoring screws that fixed each piece of the device to the adjacent vertebral bodies. These were implanted in 18 patients but yielded poor results. Due to these outcomes, the device was completely redesigned and reintroduced as the Frenchay design. A pilot study per- formed in 2002 demonstrated better results with fewer com- plications than seen with the Cummins model. The Frenchay design was later called the Prestige Cervical Disc and was approved for use in the United States in 2007. The first clini- cal trial in the US was performed in 2007 to compare the outcomes of the Prestige Cervical Disc versus traditional fusion. The results found that a patient’s ROM was main- tained at 24 months, clinical outcomes were improved and the rate of secondary surgeries were reduced when com- pared with ACDF. 1 After this trial, subsequent prototypes would soon follow: the Bryan cervical disc, PRODISC®C, the Porous Coated Motion Disc Prothesis (PCM) and the Mobi-C®, to name a few. The Bryan cervical disc was designed by neurosurgeon, Dr Vincent Bryan, in 1992. It is described as a metal-on- metal titanium implant with a polyurethane core contained Post-operative X-ray