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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 6, 713-719.
doi: 10.1302/0301-620X.91B6.22025  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Cervical spinal disc replacement

V. Denaro, MD, Professor1; R. Papalia, MD, Orthopaedic Surgeon1; L. Denaro, MD, PhD, Neurosurgeon2; A. Di Martino, MD, Orthopaedic Surgeon1; and N. Maffulli, MD, PhD, FRCS(Orth), Professor3

1 Department of Orthopaedic and Trauma Surgery, Campus Biomedico, University of Rome, Via Alvaro del Portillo, 200 00100 Rome, Italy.
2 Department of Neurosurgery, Catholic University School of Medicine, Largo Agostino Gemelli, 8. 00168, Rome, Italy.
3 Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK.

Correspondence should be sent to Professor N. Maffulli; e-mail: n.maffulli{at}qmul.ac.uk

Cervical spinal disc replacement is used in the management of degenerative cervical disc disease in an attempt to preserve cervical spinal movement and to prevent adjacent disc overload and subsequent degeneration. A large number of patients have undergone cervical spinal disc replacement, but the effectiveness of these implants is still uncertain. In most instances, degenerative change at adjacent levels represents the physiological progression of the natural history of the arthritic disc, and is unrelated to the surgeon. Complications of cervical disc replacement include loss of movement from periprosthetic ankylosis and ossification, neurological deficit, loosening and failure of the device, and worsening of any cervical kyphosis. Strict selection criteria and adherence to scientific evidence are necessary. Only prospective, randomised clinical trials with long-term follow-up will establish any real advantage of cervical spinal disc replacement over fusion.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General