This video explains Cervical Arthroplasty in combination with a fusion. When people have more than one cervical disc which has degenerated or which has sustained a traumatic rupture they may need a procedure to address both levels. These herniations may begin to affect the surrounding nerves and/or spinal cord. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Cervical Herniations/ Radiculopathy at multiple levels feel free to look us up online www.beverlyspine.com or call toll free 1-8SPINECAL-1

1. Pablo Pazmi ño, MD

10. Joint Facet Nucleus Pulposus Right Nerve Root Left Nerve Root As you can see here on MRI and CT scans the Facet joints end up looking like the buns of a hamburger. Its just the way the happen to look when they are sliced in this plane. We will show you this on some examples later Annulus Fibrosus Axial View of the Disc and Neural elements

11. Joint Facet Disc Right Nerve Root Left Nerve Root Axial View

17. Joint Facet Disc Right Nerve Root Left Nerve Root Axial View

18. Joint Facet Disc Right Nerve Root Left Nerve Root Next I will show you some MRIs You will see this is a patient with a left sided herniation pinching off her exiting left nerve root

19. Joint Facet Disc Right Nerve Root Left Nerve Root Axial Scans:

20. Cervical 7 Spinous Process Nerves 2-3 Disc 3-4 Disc 4-5 Disc 5-6 Disc 6-7 Disc

32. Sheath • Designed to minimize tissue in-growth & debris migration • Allows for full range of motion Fixation • Titanium endplates with tri-keel design • Titanium Plasma Spray (TPS) coated endplate • Low profile keel height (2mm)

35. Discover ADR Immediate and initial fixation is provided through 6 Lateral Teeth which notch into the subchondral bone of the vertebral bodies above and below the implant itself.

36. Prodisc ADR Immediate and initial fixation is provided through a keel which notch into the subchondral bone of the vertebral bodies above and below the implant itself.

37. M6 ADR Immediate and initial fixation is provided through a keel which notch into the subchondral bone of the vertebral bodies above and below the implant itself.

38. Prestige ADR Immediate and initial fixation is provided through interbody screw fixation which secure into the subchondral bone of the vertebral bodies above and below the implant itself. Angled screws to resist pullout

41. Flexion / Extension Literature: Panjabi, White (1990) Prestige +/- 10 Degrees Prodisc +/- 20 Degrees M6 6 Degrees 20 ° Unlimited

42. Lateral Bending Literature: Panjabi, White (1990) Prestige +/- 10 degrees Prodisc +/- 20 degrees M6 6 degrees 15 ° Discover 42 °

43. Axial Rotation Literature: Panjabi, White (1990) 14 ° Unlimited

47. Zero Profile Implant C L Lordosis Disc Height Heights: 3 Heights: 6mm, 7mm & 8mm 2 Footprints: Medium & Large

51. Teamwork: All Procedures performed with both an Orthopaedic Spine Surgeon and a Neurological Surgeon