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<meta name="DC.Title" content="Cervical and Lumbar Spinal Arthroplasty: Clinical Review" />
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<meta name="DC.Description" content="SUMMARY: In contrast to cervical and lumbar fusion procedures, the principal aim of disk arthroplasty is to recapitulate the normal kinematics and biomechanics of the spinal segment affected. Following decompression of the neural elements, disk arthroplasty allows restoration of disk height and maintenance of spinal alignment. Based on clinical observations and biomechanical testing, the anticipated advantage of arthroplasty over standard arthrodesis techniques has been a proposed reduction in the development of symptomatic ALD. In this review of cervical and lumbar disk arthroplasty, we highlight the clinical results and experience with standard fusion techniques, incidence of ALD in the population of patients with surgical fusion, and indications for arthroplasty, as well as the biomechanical and clinical outcomes following arthroplasty. In addition, we introduce the devices currently available and provide a critical appraisal of the clinical evidence regarding arthroplasty procedures.

ACDF
:   anterior cervical diskectomy and fusion
ALD
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AOR
:   axis of rotation
BAK
:   Bagby and Kuslich
DDD
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HO
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NDI
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ODI
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RCT
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ROM
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<meta name="DC.Contributor" content="R. Germain" />
<meta name="DC.Contributor" content="L.M. Tumialan" />
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&lt;p&gt;In contrast to cervical and lumbar fusion procedures, the principal aim of disk arthroplasty is to recapitulate the normal kinematics and biomechanics of the spinal segment affected. Following decompression of the neural elements, disk arthroplasty allows restoration of disk height and maintenance of spinal alignment. Based on clinical observations and biomechanical testing, the anticipated advantage of arthroplasty over standard arthrodesis techniques has been a proposed reduction in the development of symptomatic ALD. In this review of cervical and lumbar disk arthroplasty, we highlight the clinical results and experience with standard fusion techniques, incidence of ALD in the population of patients with surgical fusion, and indications for arthroplasty, as well as the biomechanical and clinical outcomes following arthroplasty. In addition, we introduce the devices currently available and provide a critical appraisal of the clinical evidence regarding arthroplasty procedures.&lt;/p&gt;" />
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<meta name="twitter:title" content="Cervical and Lumbar Spinal Arthroplasty: Clinical Review" />
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<meta name="twitter:description" content="SUMMARY: In contrast to cervical and lumbar fusion procedures, the principal aim of disk arthroplasty is to recapitulate the normal kinematics and biomechanics of the spinal segment affected. Following decompression of the neural elements, disk arthroplasty allows restoration of disk height and maintenance of spinal alignment. Based on clinical observations and biomechanical testing, the anticipated advantage of arthroplasty over standard arthrodesis techniques has been a proposed reduction in the development of symptomatic ALD. In this review of cervical and lumbar disk arthroplasty, we highlight the clinical results and experience with standard fusion techniques, incidence of ALD in the population of patients with surgical fusion, and indications for arthroplasty, as well as the biomechanical and clinical outcomes following arthroplasty. In addition, we introduce the devices currently available and provide a critical appraisal of the clinical evidence regarding arthroplasty procedures.

ACDF
:   anterior cervical diskectomy and fusion
ALD
:   adjacent-level degenerative disease
AOR
:   axis of rotation
BAK
:   Bagby and Kuslich
DDD
:   degenerative disk disease
HO
:   heterotopic ossification
NDI
:   neck disability index
ODI
:   Oswestry Disability Index
RCT
:   randomized controlled trial
ROM
:   range of motion
SF-36
:   Short Form 36
UHMWPE
:   ultrahigh molecular weight polyethylene
VAS
:   Visual Analog Scale" />
<meta name="og-title" property="og:title" content="Cervical and Lumbar Spinal Arthroplasty: Clinical Review" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/9/1631" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="SUMMARY: In contrast to cervical and lumbar fusion procedures, the principal aim of disk arthroplasty is to recapitulate the normal kinematics and biomechanics of the spinal segment affected. Following decompression of the neural elements, disk arthroplasty allows restoration of disk height and maintenance of spinal alignment. Based on clinical observations and biomechanical testing, the anticipated advantage of arthroplasty over standard arthrodesis techniques has been a proposed reduction in the development of symptomatic ALD. In this review of cervical and lumbar disk arthroplasty, we highlight the clinical results and experience with standard fusion techniques, incidence of ALD in the population of patients with surgical fusion, and indications for arthroplasty, as well as the biomechanical and clinical outcomes following arthroplasty. In addition, we introduce the devices currently available and provide a critical appraisal of the clinical evidence regarding arthroplasty procedures.

ACDF
:   anterior cervical diskectomy and fusion
ALD
:   adjacent-level degenerative disease
AOR
:   axis of rotation
BAK
:   Bagby and Kuslich
DDD
:   degenerative disk disease
HO
:   heterotopic ossification
NDI
:   neck disability index
ODI
:   Oswestry Disability Index
RCT
:   randomized controlled trial
ROM
:   range of motion
SF-36
:   Short Form 36
UHMWPE
:   ultrahigh molecular weight polyethylene
VAS
:   Visual Analog Scale" />
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      <h1 class="highwire-cite-title" id="page-title">Cervical and Lumbar Spinal Arthroplasty: Clinical Review</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T.D. Uschold</span>, <span class="highwire-citation-author" data-delta="1">D. Fusco</span>, <span class="highwire-citation-author" data-delta="2">R. Germain</span>, <span class="highwire-citation-author" data-delta="3">L.M. Tumialan</span> and <span class="highwire-citation-author" data-delta="4">S.W. Chang</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1631-1641; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2758 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12083--6100612174" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T.D. Uschold </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.D.%2BUschold%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Uschold%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.D.%2BUschold%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">D. Fusco </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BFusco%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fusco%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.%2BFusco%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">R. 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Tumialan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.M.%2BTumialan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tumialan%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AL.M.%2BTumialan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">S.W. 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<p id="p-2"><strong>SUMMARY:</strong> In contrast to cervical and lumbar fusion procedures, the principal aim of disk arthroplasty is to recapitulate the normal kinematics and biomechanics of the spinal segment affected. Following decompression of the neural elements, disk arthroplasty allows restoration of disk height and maintenance of spinal alignment. Based on clinical observations and biomechanical testing, the anticipated advantage of arthroplasty over standard arthrodesis techniques has been a proposed reduction in the development of symptomatic ALD. In this review of cervical and lumbar disk arthroplasty, we highlight the clinical results and experience with standard fusion techniques, incidence of ALD in the population of patients with surgical fusion, and indications for arthroplasty, as well as the biomechanical and clinical outcomes following arthroplasty. In addition, we introduce the devices currently available and provide a critical appraisal of the clinical evidence regarding arthroplasty procedures.</p>
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<h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">ACDF<span class="def-item-dt-sep"></span></dt><dd>anterior cervical diskectomy and fusion<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">ALD<span class="def-item-dt-sep"></span></dt><dd>adjacent-level degenerative disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">AOR<span class="def-item-dt-sep"></span></dt><dd>axis of rotation<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">BAK<span class="def-item-dt-sep"></span></dt><dd>Bagby and Kuslich<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">DDD<span class="def-item-dt-sep"></span></dt><dd>degenerative disk disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">HO<span class="def-item-dt-sep"></span></dt><dd>heterotopic ossification<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">NDI<span class="def-item-dt-sep"></span></dt><dd>neck disability index<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">ODI<span class="def-item-dt-sep"></span></dt><dd>Oswestry Disability Index<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">RCT<span class="def-item-dt-sep"></span></dt><dd>randomized controlled trial<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">ROM<span class="def-item-dt-sep"></span></dt><dd>range of motion<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">SF-36<span class="def-item-dt-sep"></span></dt><dd>Short Form 36<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">UHMWPE<span class="def-item-dt-sep"></span></dt><dd>ultrahigh molecular weight polyethylene<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">VAS<span class="def-item-dt-sep"></span></dt><dd>Visual Analog Scale</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/9/1631.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 33</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2012 </div></div>
      
      
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