頚椎人工椎間板置換術

Cervical Artificial Disc Replacement

Point

・頚椎前方アプローチに必要な解剖を知り，合併症を来さないよう細心の注意を払う必要がある．

・頚椎人工椎間板置換術は圧迫解除のみならず可動性を保つことも目的であり，確実な正中設置を心掛けなければならない．

・可動性が温存される手術においては，神経根症の残存や発生を来さないように確実な椎間孔拡大術を行わなければならない．

＊本論文中、［Video］マークのある図につきましては、関連する動画を見ることができます（公開期間：2028年2月まで）。

　In Japan, cervical artificial disc replacement was approved by the Pharmaceuticals and Medical Devices Agency in December 2017, and two products, Mobi-C by Zimmer Biomet and Prestige LP by Medtronic, are on the market.

　Cervical artificial disc replacement preserves cervical motion; however, the device must be place carefully on the midline to take full advantage of its features. In addition, a reliable foraminotomy is required to cure or prevent radiculopathy due to residual foraminal stenosis.

　Artificial disc replacement（ADR）is now available for up to two consecutive intervertebral spaces, and it is now possible to combine ADR with anterior cervical discectomy（decompression）and fusion or anterior cervical discectomy as a hybrid procedure. Although the number of surgical options has increased, it may be difficult to choose a surgical method until further experience is gained.

　Even with cervical artificial disc replacement, age-related facet degeneration progresses reduce the range of motion, and cause adjacent segment disease. In addition, heterotopic ossification, a frequent complication of ADR, also causes a reduction in the range of motion; therefore, further investigation of its causes and improvements in equipment is needed.