Cervical disc replacement may be used to treat the symptoms of cervical myelopathy or radiculopathy, associated with cervical disc degeneration. Cervical myelopathy is a narrowing of the spinal canal and can cause pressure on the spinal cord (Coughlin et al. 2012). It may occur as a result of age‑related wear and tear of the cervical spine. To compensate for damage to the joints, extra bone may develop within the spine, leading to the symptoms of spondylosis (NHS Choices 2014). Cervical radiculopathy is defined as pain caused by pressure on spinal nerves which can result from a slipped disc, degeneration of the spine from wear and tear, or trauma (Caridi et al. 2011).
Cervical disc degeneration may have no symptoms, but people most commonly present between the ages of 40 and 60. It has been previously shown that 25% of adults under the age of 40 have some evidence of disc degeneration, and this number increases to 85% in people aged 60 and over (Kelly et al. 2012). In the studies included within NICE interventional procedure guidance on prosthetic intervertebral disc replacement in the cervical spine, between 52 and 60% of people with cervical disc degeneration were women, with a mean age ranging from 43 to 46 years.
NICE interventional procedure guidance on prosthetic intervertebral disc replacement in the cervical spine states that damage to the cervical discs may lead to pain and stiffness in the neck, as well as pain, pins and needles, numbness or weakness of the limbs. Pain arising from degenerative changes in the cervical spine can be very debilitating (Hisey et al. 2016). Cervical myelopathy can also lead to further problems if left untreated, including bowel and bladder dysfunction (Todd 2011). People with symptoms that cannot be resolved through conservative management, including rest, painkillers and physiotherapy, may need surgery. The aim of treatment is to relieve radicular arm pain and/or prevent progression of cervical myelopathy.