Bryan's cervical prosthesis was the first to be implanted in 2001. After evaluating its efficacy in 54 patients in European hospitals, it emerged as an alternative treatment to cervical arthrodesis in herniated disc surgeries.
Since then, short, medium, and long-term studies have been carried out, and no complications of interest have been found in relation to prosthesis dislocation, loosening, infections, or other complications. Unlike knee or hip prostheses, reinterventions are not required to replace the prosthesis. This is due to the fact that its components do not suffer significant wear, as they do not have to withstand large loads or friction between materials.
A cervical prosthesis operation, for example for a cervical herniated disc, lasts around 75 minutes, in which general anesthesia is used and requires extensive experience in the surgeons who perform it.
Regarding surgery, it is performed through an anterolateral approach to the neck with an incision in the skinfold of about 3 cm. The tissues anterior to the sternocleidomastoid muscle are dissected and separated, directly reaching the anterior border of the spine. This is a very common and frequent approach in which complications usually do not arise.
Subsequently, a spacer is placed, the intervertebral disc is removed (discectomy), and the posterior herniated disc is removed. This is the fundamental step of the surgery and requires extensive experience. Thanks to the use of magnifying glasses with a light source or microscope, we ensure a complete release, removing all the hernia and possible bone excrescences (osteophytes) that may compress the nerve or spinal cord. After an abundant wash with physiological saline, the cervical prosthesis is implanted by means of radiological control. Finally, a suction net is placed, and the approach is closed in the different planes.