Uncovertebral Anatomic Midline Targeting for Cervical Disc Arthroplasty

Study Design Prospective observational cohort. Objective To document the accuracy of uncovertebral anatomic targeting in positioning cervical disc arthroplasty. Summary of Background Data Disc arthroplasty implants depend on midline placement for optimum mechanical function. Fluoroscopy is used to delineate the midline. Anatomic targeting from the uncovertebral joints in the neck may be adequate. We have investigated the efficacy of uncovertebral anatomic targeting for cervical disc arthroplasty. Methods Anatomic uncovertebral midline targeting for disc arthroplasty insertion was performed in 18 male (mean age 51 years, range 27 to 67) and 22 female (mean age 50, range 35 to 70) patients receiving a total of 59 implants over a 5-year period. Device insertion was under only lateral imaging control. Postinsertion operative fluoroscopy with optimized centering was used to record implant position in the anteroposterior plane, and centerline analysis was performed using cursor measurement technology from the GE PACS™ imaging system (GE Medical Systems, Mt. Prospect, IL). Results Analysis found a mean deviation from the ideal midline placement of only 0.7 mm (range, 0 to 2.9 mm). Only three devices were more than 2 mm off the anatomic midline. Conclusion This anatomic technique is effective, safely minimizing imaging resource needs and X-ray exposure to the patient and operating team.