I am frequently asked to lecture on the pros and cons of the artificial disc because of my familiarity with motion preservation literature written nationally and internationally. Throughout my career, I have studied Adjacent Segment Degeneration and technique for maintaining the natural balance of the spine, which is a major consideration in preserving motion of the spine.

Lumbar and cervical motion preservation technology should be viewed separately due to the anatomical difference, the range of motion, and sheer force each spinal area absorbs during day to day life. It is clear from an analysis of current clinical trials that lumbar and cervical outcomes diverge. I believe that the fundamental concept of lumbar artificial discs will prove to be valid after the current rudimentary technologies have evolved.

Though a healthy spine has little range of motion, the importance of range of motion in the cervical spine is much greater than that of the lumbar spine. While single level fusion in the cervical spine generally does not result in a loss of motion, cervical fusion over multiple segments can significantly impact functional movement of the head and neck. Compared to the lumbar spine forces, the cervical spine absorbs less impact during normal movement, as in walking, which may preserve the longevity of the implant. The most important factor from an anatomical standpoint is the cervical spine's proximity to the skin. If the implant fails, in most cases it can be revised with an anterior cervical fusion without the life-threatening complications present in the lumbar disc revision procedure.

It is for these reasons that I will consider Cervical Artificial Disc as a treatment option for some patients. Hopefully in the not-too-distant future gene therapy technologies will be applied so that the patient's own disc can be reconstituted and restored to its natural function. In the meantime, fusion or artificial disc devices will be used to treat these conditions.