Introduction The PCM cervical disc arthroplasty is an un-constrained system that stabilises the cervical spine after a discectomy and preserves the normal motion of the spine. The indications for cervical arthroplasty are the same as for anterior cervical decompression-radiculopathy or myelopathy caused by anterior cervical cord compression. The purpose of this study is to evaluate the clinical and radiological results after total anterior cervical disc replacement with PCM prosthesis.

Methods This is a prospective radiological and clinical study of patients who had undergone PCM total disc replacement with 27 months follow-up. Pain visual analog scale (VAS) and Oswestry disability index (ODI) were measured pre-operatively and at three monthly intervals out to 27 months post-operatively. Radiological images were also collected. All pain symptoms and the new neurological findings were noted.

Results Between December 2002 and February 2005 one hundred and fifteen patients underwent a total of 193 PCM arthroplasty to C3-C4 to C7-T1. Long-term clinical data on the PCM device are reported.

The neural decompression was a standard Smith-Robinson followed by a cervical arthroplasty. Eighteen PCM cases had been performed as complex revision procedures. Mean intra-operative blood loss was 113cc. Mean length of surgery was 80.7 minutes and the length of hospital stay ranged from out-patient to 3 days with 82% of patients discharged in less than 24 hours. Oswestry, VAS and Odom outcome showed significant improvements.

Discussion The PCM cervical arthroplasty appeared to be less invasive than alternative instrumented fusion procedures. The procedure allowed reconstruction of more unstable conditions than previously reported with disc replacement. Careful and appropriate patient selection is essential. Only after long-term follow-up will these early favorable results confirmed.