Disc Replacement: Postoperative Imaging

Cervical arthroplasty is being increasingly used for the management of degenerative spinal disease. As more experience is obtained with the devices currently available, the need for postoperative imaging has heightened. Plain X-rays are still useful for the assessment of device positioning and range of motion and to rule out potential device migration. CT scanning can be combined with this but incorporation of newer devices into bony endplates is difficult to visualize. In cases where neural structures need to be assessed at operated or adjacent levels MR scanning is suitable in most titanium-based devices but produces significant artifact in cobalt-chromium alloy-based devices. In this latter group CT myelography, more invasive than MR scanning, will need to be utilized. As our experience with the devices and their imaging increases, these recommendations may change but material properties play a greater role in the decision-making of type of modality used for postoperative imaging in scenarios where interbody fusion is performed.