Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M....

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Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel Riew JBJS Essent Surg Tech Volume os-91(Supplement 2):223-232 October 1, 2009 ©2009 by The Journal of Bone and Joint Surgery, Inc.

Transcript of Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M....

Page 1: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy

by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel Riew

JBJS Essent Surg TechVolume os-91(Supplement 2):223-232

October 1, 2009

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Photograph demonstrating the proper positioning for a patient undergoing cervical disc arthroplasty.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

A: If the neck of the patient has been placed in a hyperextended position, the posterior aspect of the disc space is narrowed in comparison with the anterior aspect.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

If the prosthesis is in kyphosis, then it may limit how much flexion can occur across the motion segment.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Fig. 4 Intraoperative photograph demonstrating the use of a Leksell rongeur to resect all anterior osteophytes so that the anterior margin of the disc space is flush with the rest of the vertebral

body.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Photograph demonstrating the lateral extent of the exposure needed to obtain a thorough decompression.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 13: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Intraoperative photograph demonstrating the insertion of a cervical disc arthroplasty device.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.

Page 14: Cervical Disc Arthroplasty Compared with Arthrodesis for the Treatment of Myelopathy by Jacob M. Buchowski, Paul A. Anderson, Lali Sekhon, and K. Daniel.

Postoperative anteroposterior (Fig. 9-A) and lateral (Fig. 9-B) plain radiographs of a forty-three-year-old man with C6-C7 spondylosis who underwent total disc arthroplasty.

Jacob M. Buchowski et al. J Bone Joint Surg Am 2009;os-91:223-232

©2009 by The Journal of Bone and Joint Surgery, Inc.