[Artificial disc replacement for the treatment of cervical disc herniation].

Objective: To investigate the clinical efficacy of artificial cervical disc replacement for cervical disc herniation.

Methods: Retrospective analysis of 24 patients with cervical disc herniation with 24 segments admitted from July 2016 to July 2022, including 12 males and 12 females, with an average age of (50±2) years old ranging from 36 to 68 years old. The intervertebral space height of the lesion segment before replacement was 4.3 to 7.2 mm with an average of (5.6±1.6) mm, the range of motion of anterior flexion and posterior extension was 5.6° to 7.2° with an average of (6.4±1.3)°, the range of motion for the left and right lateral flexion was 10.2° to 11.4° with an average of (10.7±1.8)°, and the Japanese Orthopaedic Association (JOA) score was 8 to 13 scores with an average of (8.0±0.3) scores. Through anterior incision, artificial cervical disc replacement surgery was performed after cervical discectomy and decompression.

Results: After surgery, all patients'incisions healed well. All patients were followed up from 12 to 60 months with an average of (33±12) months. At the final follow-up, the intervertebral space height of replacement segment was 4.0 to 6.8 mm with an average of (5.4±1.3) mm, the range of motion of anterior flexion and posterior extension was 4.6° to 6.4°with an average of (5.6±1.2)°, the range of motion of left and right lateral flexion was 8.7°to 10.3°with an average of (9.5±1.5)°. The prosthesis did not shift or sink, slight heterotopic ossification occurred within the operative segment(ⅠorⅡgrade). The height of adjacent intervertebral spaces was not lost, there was no vertebral degeneration, no significant change in the comparison of adjacent segment mobility before and after surgery. The JOA score increased from (8.0±0.3) scores before replacement operation to (15.0±0.2) scores after operation.

Conclusion: Artificial cervical disc replacement surgery can not only obtain the same efficacy as the anterior cervical disc fusion surgery, but also avoid the increase of compensatory stress of adjacent segments, maintain the stability of the biomechanical environment, thereby reducing the incidence of degeneration of adjacent segments, and can be used as an effective method for the treatment of cervical disc herniation, , but the long-term efficacy and the existing problems of replacement surgery need to be further studied and solved in the future.