The Prestige cervical disc replacement.

Abstract

BACKGROUND CONTEXT: Anterior cervical discectomy and arthrodesis is the preferred treatment for a large number of patients with symptomatic cervical spondylosis. This management strategy is successful for the majority of patients, and the short-term results are very good. There is the potential to further improve patient outcome and the long-term success rate. PURPOSE: The purpose of this report is to review the rationale for cervical arthroplasty and describe the development of the Prestige cervical disc replacement (Medtronic Sofamor Danek, Inc., Memphis, TN). STUDY DESIGN/SETTING: This report reviews the literature concerning the need for cervical arthroplasty and details the basic and clinical work on the Prestige cervical disc replacement. METHODS: The key publications concerning the shortcomings of cervical arthrodesis and the clinical and basic studies on the Prestige cervical disc implant are discussed. New long-term clinical data on the Prestige device are reported. RESULTS: Cervical arthrodesis perturbs normal cervical spinal biomechanics and appears to be associated with accelerated degeneration of the adjacent segments. The Prestige cervical disc replacement is successful in preserving normal spinal motion, both experimentally and clinically. The device is durable, and the clinical outcomes have been excellent. CONCLUSIONS: The Prestige cervical disc replacement is an effective means of reconstructing the cervical spine after anterior discectomy. It preserves normal motion and may decrease the incidence of adjacent segment disease.