The intervertebral disc prosthesis is a motion-preserving implant used to replace a degeneratively altered Intervertebral disc. The aim is to restore disc height, segmental mobility, and sagittal balance while avoiding segmental fusion. In neurosurgery, it is used primarily in the cervical spine (HWS)[^2]. Intervertebral disc prostheses in the lumbar spine (LWS) are now rarely performed[^1].
Background
Traditionally, the standard surgical treatment for symptomatic disc degeneration has been fusion of the affected spinal segment. However, stiffening eliminates physiological mobility, which may cause increased stress on adjacent segments over the long term. The intervertebral disc prosthesis was developed to preserve segmental mobility and potentially reduce the risk of so-called Adjacent Segment Disease (ASD).
Indication
Cervical intervertebral disc prostheses are particularly suitable for younger patients. Typical indications may include the following:
Cervical Radiculopathy due to disc herniation
Cervical Myelopathy in focal disc disease
Monosegmental or selected bisegmental degeneration
Preserved Facet joints
Absence of relevant instability
Evidence
For cervical intervertebral disc prostheses, numerous randomized studies have demonstrated at least equivalent, and in some cases even superior, clinical efficacy compared with fusion (ACDF). Advantages include, in particular, preservation of mobility and a lower reoperation rate at adjacent segments[^3] [^4].
Imaging
Mobility of an intervertebral disc prosthesis can be demonstrated on flexion and extension radiographs of the cervical spine.
