Cervical Disk Arthroplasty: Surgical Technique

Purpose: Cervical disk arthroplasty (CDA) has emerged as a promising alternative to anterior cervical discectomy and fusion for the management of cervical disk degeneration causing neurological symptoms. This manuscript and accompanying digital content demonstrate the senior author's preferred surgical technique for a single-level CDA. Methods: CDA is performed using a standard, left-sided Smith Robinson approach. A complete discectomy is performed, with resection of the posterior longitudinal ligament and decompression of the neuroforamina bilaterally. Careful endplate preparation and trial is performed, and the final implant is impacted under a combination of direct visualization and fluoroscopy. Postoperatively, a soft collar is worn for comfort, and the patient is discharged on postoperative day 1 or 2. Results: This video, Supplemental Digital Content 1, http://links.lww.com/CLINSPINE/A254 presents the case of a 43-year old woman with mild cervical spondylosis with a paracentral disk herniation causing left C6 radiculopathy refractory to conservative measures. A C5-6 cervical disk arthroplasty was performed. Conclusions: CDA presents a motion-sparing alternative to anterior cervical discectomy and fusion and has the potential to reduce adjacent segment disease, though further studies are needed to fully determine its benefits and expanding indications. Careful patient selection and proper surgical technique, as demonstrated here, remain crucial in optimizing outcomes.