Complications of Cervical Disc Arthroplasty

Anterior cervical discectomy and fusion (ACDF) has long been the gold standard for the treatment of cervical pathology. ACDF, when performed successfully, has shown good disease-free survival of up to 89% at 5 years for patients. However, the potential for complications has prompted clinicians to search for alternatives to cervical discectomy and fusion. Recent efforts have focused on total disc arthroplasty and interest in its application to the cervical spine. If performed successfully, total disc arthroplasty would preclude the need for graft harvest for fusion, attempt to maintain more physiological kinematics of the cervical spine and prevent/delay adjacent segment disease. Currently, at least 2 devices for cervical disc arthroplasty have been approved by the US Food and Drug Administration (FDA) for clinical use while several others are still under investigation. We hope that these new devices will have a positive effect on the treatment of cervical radiculopathy and myelopathy, but from their inception to current clinical use they too have met with difficulties and complications. Such complications include: subsidence, dislocation and heterotopic ossification. Researchers and clinicians continue to peruse the development of more robust devices to meet the growing needs of surgeons who treat such pathology of the cervical spine.