scholarly journals Long-term Follow-Up Results of Dynamic Cervical Implant in Patients with Cervical Disc Diseases: Compared with Prestige LP

2021 ◽  
Author(s):  
Li Zou ◽  
Hao Liu ◽  
Xin Rong ◽  
XIjiao Liu ◽  
Chen Ding ◽  
...  
Keyword(s):  
Short Form ◽  
Degenerative Disease ◽  
Cervical Disc ◽  
Neural Function ◽  
Cervical Disc Replacement ◽  
Dynamic Cervical Implant ◽  
Functional Spinal Unit ◽  
Flexion Extension ◽  
The Prestige

Background and Study Aims: Prestige LP arthroplasty has been proven to be a safe and effective treatment for patients with cervical disc degenerative disease (DDD). Dynamic Cervical Implant (DCI) has emerged as a novel implantation device for cervical DDD. This study aimed to compare the outcomes of these procedures after 5 years of follow-up in the DCI and Prestige LP groups. Key words: cervical disc degenerative disease; cervical disc replacement; Dynamic Cervical Implant; Prestige LP Materials and Methods: This study retrospectively enrolled 79 consecutive cervical DDD patients with 41 DCI and 47 Prestige LP prostheses implanted. Radiographs were analyzed for intervertebral height and range of motion (ROM). Neural function of the participants was assessed using the Neck Disability Index score, Visual Analog Scale, Japanese Orthopaedic Association score and 36-Item Short Form Survey. Results: The DCI group had statistically lesser flexion/extension and bilateral bending ROM than the Prestige LP group at the operated level(s) (p<0.05). The DCI group showed improved lordotic alignment of C2–C7 and operated functional spinal unit than the Prestige LP group (p<0.05). No statistical difference was observed in the neural function of the two groups. Heterotopic ossification was found in 7 and 14 patients in the DCI and Prestige LP groups, respectively. Conclusion: The 5 years follow-up results were comparable between the two groups. We believe that DCI implantation is a safe and effective procedure and could possibly become an alternative treatment for cervical DDD.

scholarly journals A Novel Preoperative Radiographic Scoring System To Predict Postoperative Outcomes in Patients Undergoing Cervical Disc Replacement Surgery

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Yahya Othman ◽  
Todd Albert ◽  
Russell Huang ◽  
Philip York ◽  
Avani Vaishnav ◽  
...  
Keyword(s):  
Scoring System ◽  
Short Form ◽  
Disc Height ◽  
Cervical Disc ◽  
Radiographic Assessment ◽  
Cervical Disc Replacement ◽  
Outcomes Measures ◽  
Patient Reported ◽  
The Impact

Abstract INTRODUCTION The purpose of this study was to use a novel scoring system to quantify the level of degenerative change within the disc space, uncus, and facet joints, and determine the impact of worsening degenerative changes on postoperative outcome. METHODS Preoperative lateral and AP radiographs were collected and scored by 3 spine surgeons based on disc height, facet arthrosis, and uncovertebral joint degeneration. Each of the categories was scored from 0 to 2. These scores were separately used in the analysis to assess which component correlated with outcomes of surgery. An overall score for preoperative radiographic assessment was calculated as the sum of these 3 scores and also used in the analysis. Surgical outcomes were assessed by 5 patient reported outcomes measures (PROMs); Visual Analogue Scale (VAS) arm, VAS neck, Neck Disability Index (NDI), and Short Form 12 Physical health (SF12-P) and mental health (SF12-M). RESULTS Radiographs of 85 patients that underwent CDR were assessed. Of those, 60 were single-level and 25 were two-level surgeries. A total of 44 patients were deemed to have adequate follow up, while 41 patients were excluded from the analysis due to inadequate follow-up. Interrater reliability for radiographic assessment was good to excellent. The included patients had a mean follow-up of 8 mo, ranging from 6 to 24 mo. At latest follow-up, preoperative facet arthrosis showed a statistically significant correlation with NDI and VAS neck outcomes measures (P = .016, P = .013, respectively). However, disc height and uncovertebral degeneration did not correlate with any of the collected PROMs (P > .05 for all). CONCLUSION Preoperative health of the facet joint at the surgical level had a significant impact on patient perceived neck pain and disability at the latest follow up. It is important for patient selection to be refined to reflect a focus on factors that can impair success of CDR surgery.

A Correlation Analysis Between Postoperative Dysphagia and Change of C2-C7 Angle after Anterior Cervical Spine Surgery

2021 ◽  
Author(s):  
Jie Yu ◽  
Xiaohui Tao
Keyword(s):  
Cervical Spine ◽  
Spinal Surgery ◽  
Cervical Disc ◽  
Cervical Lordosis ◽  
Postoperative Dysphagia ◽  
Cervical Spine Surgery ◽  
Cervical Disc Replacement ◽  
Anterior Cervical Spine Surgery ◽  
Angle Change

Abstract Background. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities in clinical practice. Studies suggest that excessive O-C2 angle change at occipital-cervical fusion causes the oropharyngeal volume reduction leading to severe dysphagia and even respiratory distress after operation. However, rare study has accessed the impact of C2-C7 angle change on the occurrence of dysphagia after anterior cervical spinal surgery. Methods. From June 2007 to May 2010, A total of 198 patients was treated with anterior cervical decompression and plate fixation and 12 months follow-up was completed in 172 patients. Within the same session, a total of 154 patients underwent anterior cervical disc replacement and at least 1-year follow-up was completed in 98 patients. All 270 patients who participated in this study completed a questionnaire (Bazaz dysphagia questionnaire) after telephone follow-up including the onset and time of appearance of dysphagia, symptom relief, treatment plan and so on. To determine whether excessive cervical lordosis change (change of C2-C7 angle) and other risk factors were associated with the dysphagia symptom, all patients were divided into the dysphagia group and the control group, followed over 12 months.Results. The results showed that 12.8% presented with postoperative dysphagia in anterior cervical discectomy and fusion (ACDF) group and 5.1% in cervical disc replacement (CDR) group. According to the regression equation, the excessive change of C2-C7 angle can significantly increase the incidence rate of postoperative dysphagia. The incidence rate of postoperative dysphagia in patients whose C2-C7 angle change more than 5 degree was significantly greater than patients less than 5 degree. Sex, age, BMI, operation time, blood loss, surgery approach (anterior/posterior), revision ratio, the number of surgical segments, the highest surgical segment, and C3 segment included or not cannot affect the occurrence of dysphagia. Conclusions. Dysphagia after cervical spinal surgery is one of highly prevalent comorbidities. Cervical lordosis change is an important influencing factor on the occurrence of dysphagia after anterior cervical spine surgery.

Effects of Treatment for Cervical Disc Degenerative Disease in Military Populations

2011 ◽  
Author(s):  
Joseph Cochran ◽  
Jamie L. Baisden ◽  
Narayan Yoganandan ◽  
Frank A. Pintar
Keyword(s):  
Finite Element ◽  
Degenerative Disease ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement ◽  
Bony Fusion ◽  
Bryan Disc ◽  
Cadaver Studies ◽  
External Forces ◽  
Military Patients

Numerous clinical and biomechanical evaluations of cervical disc replacement and anterior cervical discectomy and fusion as treatment of cervical disc herniation have been performed. Military patients represent a unique patient population as they may be subject to large external forces in theatre. Military patients are more susceptible to degenerative disease of the cervical spine, and if treated with single-level bony fusion, the treated level may be subject to large forces postoperatively. Literature reviews were conducted to determine patient outcomes following cervical disc replacement compared to bony fusion surgery; compare cadaver studies that evaluated the two conditions; and finite element modeling studies. In the civilian population, patients treated with each type of surgery have clinical improvement that is at least equivalent in the 2- and 5-year follow-up periods. Based on the finite element and cadaver biomechanical studies, semiconstrained devices, ProDisc-C and Prestige, are less mobile and a larger load is placed on the core of the device in comparison to the more mobile and unconstrained Bryan disc.

Cervical arthroplasty in the management of spondylotic myelopathy: 18-month results

2004 ◽  
Vol 17 (3) ◽  
pp. 55-62 ◽  
Author(s):  
Lali H. S. Sekhon
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Cervical Disc ◽  
Artificial Disc ◽  
Cervical Arthroplasty ◽  
Cervical Disc Replacement ◽  
Excellent Outcome ◽  
Anterior Cervical Decompression

Object Cervical spinal cord compression managed via an anterior approach with an arthrodesis may be associated with a decreased range of motion and accelerated adjacent-segment degeneration. Artificial cervical disc replacement may address these problems. Methods The author presents a series of 11 patients (seven men and four women, ages 31–55 years) with anterior cervical decompression and placement of a total of 15 artificial disc prostheses. Clinical and radiological follow-up review was performed at 24 hours, 6 weeks, 3 months, 6 months, and then yearly (mean follow-up period 18.4 months, range 10–32 months). There were no major complications. There was an improvement in the Nurick grade by 0.91 grades (p < 0.001) and in the Oswestry Neck Disability Index by 41.5 percentage points (p < 0.001). In one case fusion was attained at 17 months postoperatively and one patient had a transient worsening of preoperative symptoms postoperatively, with focal kyphosis. The spinal cord was decompressed on postoperative imaging in all cases. Conclusions Cervical arthroplasty after anterior cervical decompression at one or more levels represents an exciting tool in the management of spinal cord compression caused by spondylotic disease or acute disc prolapse. Results obtained in this study add further weight to the potential role of cervical arthroplasty for cervical myelopathy and longer follow up is provided on a previously reported series. It is suggested that care must be taken in using this unconstrained prosthesis if there is a preexisting spinal deformity. Longer follow up will reveal any delayed problems with artificial disc implantation, but in the short to medium term, this technique offers an excellent outcome.

scholarly journals Clinical and radiological outcome at 10 years of follow-up after total cervical disc replacement

2017 ◽  
Vol 26 (9) ◽  
pp. 2441-2449 ◽  
Author(s):  
Christoph Mehren ◽  
Franziska Heider ◽  
Christoph J. Siepe ◽  
Bernhard Zillner ◽  
Ralph Kothe ◽  
...  
Keyword(s):  
Disc Replacement ◽  
Cervical Disc ◽  
Radiological Outcome ◽  
Cervical Disc Replacement ◽  
Clinical And Radiological Outcome

scholarly journals Four-year results of a prospective single-arm study on 200 semi-constrained total cervical disc prostheses: clinical and radiographic outcome

2016 ◽  
Vol 25 (5) ◽  
pp. 556-565 ◽  
Author(s):  
Hans-Jörg Meisel ◽  
Lubomír Jurák ◽  
Jussi Antinheimo ◽  
Ricardo Arregui ◽  
Bernhard Bruchmann ◽  
...  
Keyword(s):  
Total Disc Replacement ◽  
Neck Disability Index ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Adjacent Segment ◽  
Radiographic Outcome ◽  
Cervical Disc Replacement ◽  
Arm Pain ◽  
Facet Joint Degeneration

OBJECTIVE Recent studies have described encouraging outcomes after cervical total disc replacement (cTDR), but there are also critical debates regarding the long-term effects of heterotopic ossification (HO) and the prevalence of adjacent-level degeneration. The aim in this paper was to provide 4-year clinical and radiographic outcome results on the activ C disc prosthesis. METHODS A total of 200 subjects underwent single-level activ C (Aesculap AG) implantation between C-3 and C-7 for the treatment of symptomatic degenerative disc disease. Clinical and radiographic assessments were performed preoperatively, intraoperatively, at discharge, and again at 6 weeks, 6 months, 1 year, 2 years, and 4 years. Radiographic evaluations were done by an independent core laboratory using a specific software for quantitative motion analysis. RESULTS Neck Disability Index (NDI) and visual analog scale (VAS) score for neck and arm pain decreased significantly from baseline to the 4-year follow-up. The mean improvement for NDI was 20, for VAS severity and frequency of neck pain 26.4 and 28, and for VAS severity and frequency of arm pain 30.7 and 35.1, respectively. The neurological situation improved for the majority of patients (86.4%); 76.1% of cases were asymptomatic. Subsequent surgical interventions were reported in 7% of the cases, including device removals in 3%. In 2.5% a subsidence greater than 3 mm was recorded; 1 of these cases also had a migration greater than 3 mm. No device displacement, expulsion, disassembly, loose or fractured device, osteolysis, or facet joint degeneration at the index level was observed. Segmental lordotic alignment changed from −2.4° preoperatively to −6.2° at 4 years, and postoperative height was maintained during the follow-up. Advanced HO (Grade III and IV) was present in 27.1% of the cases; 82.4% showed segmental mobility. A progression of radiographic adjacent-segment degeneration occurred in 28.2%, but only 4.5% required surgical treatment. CONCLUSIONS The activ C is a safe and effective device for cervical disc replacement confirming the encouraging results after cTDR. Clinical trial registration no.: NCT02492724 (clinicaltrials.gov)

161. Metal-on-metal vs metal-on-plastic artificial discs in 2-level anterior cervical disc replacement: a meta-analysis with follow up of 5 years or more

2021 ◽  
Vol 21 (9) ◽  
pp. S81
Author(s):  
Daniel Coban ◽  
Michael Pompliano ◽  
Stuart Changoor ◽  
Conor J. Dunn ◽  
Kumar Sinha ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement ◽  
Metal On Metal
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