General Guideline Principles for Cervical Artificial Disc
Replacement for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Cervical Artificial Disc Replacement.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Cervical Artificial Disc Replacement

Cervical Artificial Disc Replacement (Single or Two Level)

To preserve physiological mobility at the treated cervical segment, a prosthetic device is inserted into the neck cervical intervertebral space. The surgeon’s inclination and training will determine if artificial discs are used in motion-preserving technology. Only artificial discs with FDA approval are acceptable.

Cervical Arthroplasty is Indicated in Patients Meeting the Following Criteria:

• skeletally developed
• Myelopathy or myeloradiculopathy from C3-4 to C6-7 with or without neck discomfort caused by one or two levels of degenerative disease (either invertebrate /herniated disc or spondylotic osteophyte).
• cervical radiculopathy and disease of the spinal cord with clinical symptoms brought on by C3-C7 neural compression at one level or two adjacent levels.
• failed at least six months of nonsurgical therapy by medical treatment recommendations or exhibits evidence of the deteriorating clinical condition.
  • persistent or recurring discomfort or pain that limits function and is refractory to at least six months of conservative care that follows medical treatment recommendations; AND
  • failure of any two of the following doctor-recommended conservative therapies for at least 6 weeks straight:
    1. NSAIDs, analgesics, and/or steroids
    2. Physical therapy program that is organized
    3. an organized home workout regimen recommended by a physical psychologist, chiropractor, or doctor
    4. Facet injections, epidural steroid injections, or selective nerve root blocks; AND
       Imaging tests (MRI or CT) that establish the existence of curtailment at level(s) consistent with clinical findings
       no neck surgery previously.

Cervical Artificial Disc Replacement is NOT indicated when any of the following clinical scenarios exist:

• a three or more level sickness with many symptoms
• illness that has developed close to a prior cervical fusion
• Disease (at the site of infix, or systemic) (at the site of implantation or systemic)
• osteopenia or osteoporosis
• Instability
  • At the symptomatic levels, translation more than 3mm discrepancy between lateral flexion-extension views.
  • The lateral flexion-extension perspective at the indicative levels varied by 11 degrees in angle.
• allergy or sensitivity to implant materials
• What is severe spondylosis?
  • > 50% reduction in disc height from minimally or fully degenerated levels
  • Osteophytes that connect.
  • At the location of the symptoms, there is no mobility on the lateral flexion-extension views.
• significant facet arthropathy
• spondylitis with ankylosing
• arthritis rheumatoid
• prior fracture accompanied with an anatomical abnormality
• posterior longitudinal ligament ossification (OPLL)
• active cervical spine cancer
  • > 50% reduction in disc height from minimally or fully degenerated levels; (^)
  • Osteophytes that connect: (^)
  • At the location of the symptoms, there is no mobility on the lateral flexion-extension views. (^)

What our office can do if you need Cervical Artificial Disc Replacement

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.