Effects of Removal of Uncinate Process in a Cervical Disc Replacement Model: A Finite Element Based Study

Anterior surgical approach is commonly used for Total Disc Replacement (TDR) surgeries in the cervical spine. The general procedure includes removal of the nucleus and anterior annulus of the intervertebral disc. Resection of Anterior Longitudinal Ligaments (ALL) is often performed to enter the disc space. The cervical spine also contains a unique anatomical feature called Luschka’s joints. These “joints” are actually fissures in the disc which run approximately parallel to the uncinate processes. These joints are thought to provide biomechanical stability to the cervical spine. However, sometimes surgeons have to sacrifice the uncinate processes at the involved level as well. We hypothesized that the cervical spine loses stability if the uncinate processes are removed along with disc replacement. We used a Finite Element (FE) model of cervical spine to prove the hypothesis (Fig1).