Radiological follow-up after implanting cervical disc prosthesis in anterior discectomy: a systematic review

ObjectivesThe study aims to evaluate the radiological, clinical efficacy and safety of a novel compressible cervical disc prosthesis in the treatment of degenerative cervical radiculopathyDesignObservational non-randomised case series based in two centres.Subjects101 consecutive patients (137 artificial discs) treated for cervical radiculopathy secondary to cervical disc degeneration. Mean age at operation 45.4 years.MethodsNeck Disability Index, Visual Analogue Score for neck and arm pain, Euro Quality of Life −5D survey, index level range of movement, heterotopic ossification, adjacent level disease, re-intervention rate and safety profile were assessed. Clinical (outpatient and telephone questionnaires) and radiological (Nuvaline and McKeeson PACS suites) were employedResultsIndex range of movement was 7.9 degrees pre operatively and 7.6 at two years. 2 re operations at supradjacent levels took place post treatment in a 35 month follow-up period. 1 post-operative haematoma and 1 delayed infection occurred. All four primary outcome measures exhibited significant improvement from baseline to last follow up; NDI (47.5 to 24.9, p<0.001) EURO QOL index (0.36 to 0.84, p<0.0001) and VAS Arm (5.6 to 0.85 p<0.0001) and VAS Neck (7.1 to 1.7, p<0.0001).ConclusionsThe compressible disc prosthesis preserved 96.2% of the initial range of movement at index level whilst exhibiting a favourable re operation rate and safety profile.

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Cervical disc prosthesis: 2-year follow-up

Coluna/Columna ◽

10.1590/s1808-185120151402113265 ◽

2015 ◽

Vol 14 (2) ◽

pp. 85-87

Author(s):

Romero Pinto de Oliveira Bilhar ◽

Alexandre Fogaça Cristante ◽

Raphael Martus Marcon ◽

Ivan Dias da Rocha ◽

Olavo Biraghi Letaif ◽

...

Keyword(s):

Medical Records ◽

Epidemiological Data ◽

Cervical Disc ◽

Safe Procedure ◽

Disc Prosthesis ◽

Cervical Arthroplasty ◽

Cervical Disc Prosthesis ◽

The Mean

<sec><title>OBJECTIVE:</title> To review the medical records of patients who underwent surgery for placement of cervical disc prosthesis after two years of postoperative follow-up, showing the basic epidemiological data, the technical aspects and the incidence of complications.</sec><sec><title>METHODS:</title> Medical records of seven patients who underwent surgery for placement of cervical disc prosthesis were reviewed after two years of follow-up, at the Institute of Orthopedics and Traumatology, Faculty of Medicine, University of São Paulo.</sec><sec><title>RESULTS:</title> The average age of patients participating in this study was 43.86 years. Six patients (85.7%) had one level approached while one patient (14.3%) had two levels addressed. The level C5-C6 has been approached in one patient (14.3%) while the C6-C7 level was addressed in five patients (71.4%). One patient (14.3%) had these two levels being addressed, C5-C6 and C6-C7. The mean operative time was 164.29±40 minutes. Three patients were hospitalized for 2 days and four for 3 days making an average of 2.57±0.535 days. Two patients (28.6%) underwent a new surgical intervention due to loosening of the prosthesis. The mean follow-up was 28.14±5.178 months (23-35 months).</sec><sec><title>CONCLUSIONS:</title> Although cervical arthroplasty appears to be a safe procedure and present promising results in our study as well as in many other studies, it requires long-term studies.</sec>

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A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan Cervical Disc Prosthesis

Journal of Neurosurgery Spine ◽

10.3171/2009.9.spine09129 ◽

2010 ◽

Vol 12 (3) ◽

pp. 261-269 ◽

Cited By ~ 65

Author(s):

Jan Goffin ◽

Johan van Loon ◽

Frank Van Calenbergh ◽

Bailey Lipscomb

Keyword(s):

Adverse Events ◽

Clinical Studies ◽

Angular Motion ◽

Disc Replacement ◽

Long Term Results ◽

Cervical Disc ◽

Disc Prosthesis ◽

Cervical Disc Replacement ◽

Cervical Disc Prosthesis

Object In this study, long-term results are presented from clinical studies of the Bryan Cervical Disc Prosthesis at University Hospital Gasthuisberg in Leuven, Belgium. A total of 98 patients (89 with 1-level and 9 with 2-level implantations) agreed to participate in follow-up studies for up to 10 years postoperatively. This article focuses on the 4- and 6-year results. Patients in one of the clinical studies had either radiculopathy or myelopathy associated with spondylosis and/or disc herniations that did not respond to conservative treatment. Patients from the other clinical study received commercially available Bryan devices and the study protocol did not have specific inclusion/exclusion criteria. More than 90% of the patients were considered to have radiculopathy. Methods Clinical measurements discussed in the article include the 36-Item Short Form Health Survey, Neck Disability Index, numerical ratings of neck and arm pain, neurological outcomes, and Odom classification. Angular motion findings from lateral flexion-extension radiographs are also presented. The occurrence of adverse events and second surgeries are examined as an indicator of device safety. Results The clinical outcomes at 4 and 6 years postoperatively appear consistent with the previously reported results at 1 and 2 years postoperatively. The mean angular motion results at 4 and 6 years postoperatively for 1-level patients were 7.3 and 7.7°, respectively. Two-level patients had slightly less motion at 4 and 6 years postoperatively with mean caudad values of 5.7 and 6.0°, respectively, and cephalad values of 4.2 and 6.2°, respectively. Efforts were made to capture adverse events, regardless of their nature and relatedness to the study surgery. This effort resulted in a relatively high number of recorded events. However, only 6 patients experienced events that were judged by the investigator to be related, either possibly or definitely, to the Bryan device. These events included device migration, device removal, and hoarseness and vocal cord paralysis, as well as 3 cases involving pain and neurological symptoms. Eight patients underwent further neck surgery to treat symptoms. Conclusions The favorable clinical and angular motion outcomes that were previously noted at 1- and 2-years' follow-up after cervical disc replacement with the Bryan Cervical Disc Prosthesis appear to persist after 4 and 6 years of follow-up.

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Pretic-I was a safe and effective artificial cervical disc prosthesis--a retrospective and comparative study with 5-year follow-up

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04813-5 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Yingjun Guo ◽

Hao Liu ◽

Jianzhong Xu ◽

Yuxiao Deng ◽

Xiaoliang Tao ◽

...

Keyword(s):

Japanese Orthopaedic Association ◽

Neck Disability Index ◽

Operation Time ◽

Cervical Disc ◽

Adjacent Segment ◽

Clinical Parameters ◽

High Grade ◽

Disc Prosthesis ◽

Cervical Disc Prosthesis

Abstract Background The newly designed cervical disc prosthesis, Pretic-I, had been finished its limited clinical use for over 5 years. At a short-term follow-up of 2 years, we obtained satisfactory clinical results. The long-term clinical efficacy and safety of Pretic-I will now be analyzed. Methods Peri-operative parameters included intra-operative blood loss, operation time, off-bed time. Clinical parameters included visual analogue scale (VAS) for arm and neck, neck disability index (NDI), and Japanese Orthopaedic Association (JOA) score. Radiological parameters included C2–7 Cobb angle, Shell angle, and the range of motion (ROM) of C2–7, functional segment unit (FSU), and adjacent FSU. The CDA-related complications included adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), heterotopic ossification (HO), prosthesis subsidence, prosthesis displacement, and dysphagia. Results A total 64 patients from two independent centers received a single-level CDA with Discover (n = 32) and Pretic-I (n = 32), and all of patients finished a 5-year follow-up. There’re no significant differences between two groups in peri-operative parameters. The clinical parameters improved greatly in Pretic-I group (p<0.0001), and there’s no statistical difference from Discover group. Furthermore, Pretic-I could slightly improve the cervical curvature (15.08 ± 11.75 to 18.00 ± 10.61, p = 0.3079) and perfectly maintain the Shell angle (3.03 ± 3.68 to 2.23 ± 4.10, p = 0.1988), cervical ROM (52.48 ± 14.31 to 53.30 ± 11.71, p = 0.8062) and FSU ROM (12.20 ± 4.52 to 10.73 ± 4.45, p = 0.2002). The incidence of high-grade HO (Grade III-IV) at the final follow-up was significantly lower in Pretic-I group than in Discover group (12.50% vs. 34.38%, p = 0.0389, Statistical Power = 95.36%). The incidences of other CDA-related complications in Pretic-I group were also well-accepted, comparable to the Discover group, without significant differences. Conclusion CDA with Pretic-I demonstrated a well-accepted and sustained clinical outcome, with a significantly lower incidence of high-grade HO. This newly designed prosthesis is expected to become an alternative choice for cervical disc prosthesis in the future.

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