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One very important fact to consider is the potential risk of surgery involved in revision of disc arthroplasties. A cervical arthroplasty approach involves going into the front of the neck. Cervical spine revisions, while significant, are simpler due to more easily made surgical approaches behind the trachea and esophagus, the food and breathing tubes.
In lumbar arthroplasties the approach is made through the abdomen to the spine. In front of the lumbar spine, the great vessels (arteries and veins) going to the legs and other vital organs are mobilized. In revision surgery, there may be significant scarring of these vessels and mobilization a second time may be exceedingly difficult with risk of tearing, vascular injury to the legs, or life threatening blood loss or clots. Revision surgery should only be attempted by individuals skilled in this surgery with a vascular surgeons help.
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Cervical disk replacement | There are many types and designs of arthroplasties, some being made of two pieces of metal, others being a composite plastic and metal, and others being a polymer spacer. Research is being done on all types and eventually the field will likely be narrowed to one or two basic types with modifications on a theme. These devices are still in their infancy in design compared to total hip and knee replacements, and anyone undergoing this surgery should understand that there are no guarantees regarding the life expectancy of the disc prosthesis or the effectiveness of the pain relief. Early information has shown that these patients can have excellent results with the proper indications for surgery done by skilled surgeons.
Other technologies involve the replacement of the posterior facet joints for posterior facet pain. This type of surgery is very new and large studies with long term results have not yet been done. Time will tell if this is a viable alternative to posterior fusion for facet problems and if the technology and surgical replacements will hold up over time.
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