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T he replacement of thecervicalintervertebraldiscbyartificialimplants is becoming a generally applied method in DDD. 5 This relatively new method is competing with the gold standard of the ACDF. 10 Both procedures are used in patients with pain and/or neurological symptoms from DDD when nonsurgical treatment has failed. Several earlier studies demonstrated similar clinical results for the new method compared with the gold standard. 9 , 13 Recent studies show an improved outcome for patients who underwent CTDR. 8 However, long-term follow

R ecentartificialdisc技术迅速发展d and provided great potential for changing treatment strategies for several spinal disorders. 2, 3, 5, 6, 8, 12, 13, 16, 17, 19–26, 39, 40, 44 Specifically, in thecervicalspine, great attention has been focused on adjacent-segment disease after anterior and posterior arthrodesis. 18, 30 Although patients who present with neural compressive lesions causing radiculopathy or myelopathy often require anterior decompressive surgeries, anterior arthrodesis has generally been an unavoidable procedure

than with a posterior approach plus instrumentation. 6 , 7 The anterior surgical approach includes anteriorcervicalcorpectomy and fusion, anteriorcervicaldiscectomy and fusion (ACDF),cervicalartificialdiscreplacement (c-ADR), and hybrid procedures. 2 ACDF has long been regarded as a relatively safe, effective treatment forcervicalradiculopathy or myelopathy. 8 , 9 Later, c-ADR was developed and has been shown to be an attractive option capable of preserving motion at the surgical segment. 10 Nevertheless, previous studies have revealed that c-ADR is

-segment disease. Severalcervicalartificialdiscswere developed in the 1990s. Currently,artificialdiscscan be categorized based on several criteria, such as articulation, material, design, fixation, and kinematics. 25 With respect to material, two representative types have been developed: metal-on-metal and metal-on-polymer implants (UHMWPE). These twodiscsare different from several viewpoints. The Prestige IIcervicaldisc(Medtronic Sofamor Danek) is a stainless steel, metal-on-metal semiconstrained–bearing surface. The ProDisc-CcervicalDisc(Synthes Spine) is

progression of disease that affects some patients. Attempts at creating anartificialintervertebraldischave met with limited success. 2, 5, 11 In most clinical experiences involving such implants, surgeons have treated patients with lumbar disease (Rapp S, unpublished data). In the late 1980s Cummins, et al., 5 tried to maintain motion in thecervicalspine by using a simple ball and socket—type joint. Their technique was problematic, but in the majority of casescervicalvertebral motion was preserved. The authors concluded that further investigation intoartificial