Effects of Treatment for Cervical Disc Degenerative Disease in Military Populations

Numerous clinical and biomechanical evaluations of cervical disc replacement and anterior cervical discectomy and fusion as treatment of cervical disc herniation have been performed. Military patients represent a unique patient population as they may be subject to large external forces in theatre. Military patients are more susceptible to degenerative disease of the cervical spine, and if treated with single-level bony fusion, the treated level may be subject to large forces postoperatively. Literature reviews were conducted to determine patient outcomes following cervical disc replacement compared to bony fusion surgery; compare cadaver studies that evaluated the two conditions; and finite element modeling studies. In the civilian population, patients treated with each type of surgery have clinical improvement that is at least equivalent in the 2- and 5-year follow-up periods. Based on the finite element and cadaver biomechanical studies, semiconstrained devices, ProDisc-C and Prestige, are less mobile and a larger load is placed on the core of the device in comparison to the more mobile and unconstrained Bryan disc.