The most commonly accepted indications for cervical disc
arthroplasty (CDA) are 1- and 2-level cervical
disc herniation or
spondylosis causing
radiculopathy or
myelopathy that is refractory to medical management. Unlike anterior cervical
discectomy and fusion (ACDF), which eliminates motion, CDA aims to restore the physiological range of motion of the indexed joint. Thus, the effect of indirect
decompression gained by the insertion of a sufficiently large interbody graft and incorporation into
arthrodesis after ACDF cannot be duplicated for CDA. For patients undergoing CDA, during extreme flexion/extension or rotation, the exiting nerve roots might be impinged by inadequately decompressed foraminal
osteophytes. Therefore, the authors advocate generous
decompression, including resection of the posterior longitudinal ligament (PLL) and bilateral uncovertebral joints (UVJs), even in the asymptomatic side. This video demonstrates full dural expansion and enlarged neuroforamen after removal of the PLL and UVJs. Venous
hemorrhage encountered during
foraminotomy can always be controlled by cottonoid packing or
hemostatic agents. Also, the endplates of the surrounding vertebral bodies were meticulously prepared for parallel insertion of the ProDisc-C Nova (DePuy Synthes Spine) artificial disc. Please note that the ProDisc-C Nova is currently not available on the US market. The video can be found here: https://youtu.be/XUo34j6WFYs .