NuNec™ Cervical Disc Arthroplasty Improves Quality of Life in Cervical Radiculopathy and Myelopathy: A 2-yr Follow-up

Abstract BACKGROUND Anterior cervical disc replacement is an alternative to fusion for the treatment of selected cases of radiculopathy and myelopathy. We report clinical and radiological outcomes after disc replacement with the NuNec™ artificial cervical disc (Pioneer® Surgical Technology, Marquette, Michigan) with subgroup analysis. OBJECTIVE To review clinical and radiological outcomes after anterior cervical disc replacement with the NuNec™ artificial cervical disc. METHODS A consecutive case series of patients undergoing cervical disc replacement with the NuNec™ artificial disc was conducted. Clinical outcomes were assessed by questionnaires preoperatively and up to 2 yr postoperatively including neck and arm pain, Neck Disability Index, Euroqol 5-dimensions, and Short Form-36; x-rays from the same period were analyzed for range of movement and presence of heterotopic ossification. RESULTS A total of 44 NuNec™ discs were implanted in 33 patients. Clinical improvements were seen in all outcomes; significant improvements on the Neck Disability Index, Euroqol 5-dimensions, and physical domain of the Short Form-36 were maintained at 2 yr. There was a mean of 4° range of movement at the replacement disc level at 2 yr, a significant reduction from baseline; there was also progression in levels of heterotopic ossification. Complications included temporary dysphagia (10%) and progression of disease requiring foraminotomy (6%); no surgery for adjacent level disease was required. There was no significant difference in the outcomes of the radiculopathy and myelopathy groups. CONCLUSION Clinical outcomes using the NuNec™ disc replacement are comparable with other disc replacements. Although the range of movement is reduced, the reoperation rate is very low.

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Clinical Significance of Heterotopic Ossification in Cervical Disc Replacement: A Prospective Multicenter Clinical Trial

Neurosurgery ◽

10.1227/01.neu.0000175856.31210.58 ◽

2005 ◽

Vol 57 (4) ◽

pp. 759-763 ◽

Cited By ~ 132

Author(s):

Clarence Leung ◽

Adrian Th. Casey ◽

Jan Goffin ◽

Pierre Kehr ◽

Klaus Liebig ◽

...

Keyword(s):

Risk Factors ◽

Heterotopic Ossification ◽

Short Form ◽

Disc Replacement ◽

Cervical Disc ◽

Secondary Outcome ◽

X Rays ◽

Cervical Disc Replacement ◽

Bryan Disc ◽

Grade 3

ABSTRACT OBJECTIVE: Heterotopic ossification (HO) is a well-known complication in joint replacements, but its occurrence and clinical effect on cervical artificial discs has not yet been studied. The purpose of this study was to investigate the incidence of HO in cervical disc replacement, to identify any associated risk factors for HO, and to examine the relationship of HO with clinical outcomes. METHODS: The patient data for this observational study were obtained from the original Bryan Disc Study by the European Consortium. Occurrence of HO was defined by the McAfee classification on the cervical lateral x-rays at 12 months after surgery. Secondary outcome measurements included Odom's criteria and the Medical Outcomes Study Short-Form 36-Item Health Survey. RESULTS: Sixteen (17.8%) of the 90 studied patients experienced HO, and 6 (6.7%) of these patients experienced Grade 3 and 4 HO. Ten patients' (11%) artificial discs were shown to have movement of less than 2 degrees on flexion and extension cervical x-ray at 12 months, with 4 of these patients having HO of Grade 3 or 4. Male sex (χ2 = 4.1; P = 0.0407) and older patients (P = 0.023; odds ratio = 1.10; 95% confidence interval = 1.01–1.19) were associated with development of HO. CONCLUSION: There is a strong association of the occurrence of HO with subsequent loss of movement of the implanted cervical artificial disc. We have found that sex and age are two possible risk factors in the development of HO after cervical disc replacement.

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Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Suchomel P, Jurák L, Benes V 3rd, et al. Eur Spine J 2010;19(2):307–15. Epub 2009 Dec 25

The Spine Journal ◽

10.1016/j.spinee.2010.06.033 ◽

2010 ◽

Vol 10 (9) ◽

pp. 843

Keyword(s):

Heterotopic Ossification ◽

Clinical Results ◽

Disc Replacement ◽

Cervical Disc ◽

Cervical Disc Replacement

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Effect of intervertebral disc height on postoperative motion and clinical outcomes after Prodisc-C cervical disc replacement

The Spine Journal ◽

10.1016/j.spinee.2009.03.008 ◽

2009 ◽

Vol 9 (7) ◽

pp. 551-555 ◽

Cited By ~ 28

Author(s):

Chan W.B. Peng ◽

Martin Quirnoa ◽

John A. Bendo ◽

Jeffrey M. Spivak ◽

Jeffrey A. Goldstein

Keyword(s):

Intervertebral Disc ◽

Clinical Outcomes ◽

Disc Height ◽

Disc Replacement ◽

Cervical Disc ◽

Cervical Disc Replacement ◽

Intervertebral Disc Height

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Is Anterior Bone Loss the Opposite of Anterior Heterotopic Ossification in Prestige-LP Cervical Disc Replacement?

World Neurosurgery ◽

10.1016/j.wneu.2020.01.022 ◽

2020 ◽

Vol 136 ◽

pp. e407-e418 ◽

Cited By ~ 4

Author(s):

Xiaofei Wang ◽

Yang Meng ◽

Hao Liu ◽

Ying Hong ◽

Beiyu Wang

Keyword(s):

Bone Loss ◽

Heterotopic Ossification ◽

Disc Replacement ◽

Cervical Disc ◽

Cervical Disc Replacement

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

Journal of Neurosurgery Spine ◽

10.3171/2016.3.spine15810 ◽

2016 ◽

Vol 25 (5) ◽

pp. 556-565 ◽

Cited By ~ 15

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)

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87. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial

The Spine Journal ◽

10.1016/j.spinee.2004.05.088 ◽

2004 ◽

Vol 4 (5) ◽

pp. S45

Author(s):

Clarence Leung ◽

Adrian Th Casey ◽

Jan Goffin ◽

Pierre Kehr ◽

Klaus Liebig ◽

...

Keyword(s):

Clinical Trial ◽

Heterotopic Ossification ◽

Clinical Significance ◽

Disc Replacement ◽

Cervical Disc ◽

Multicenter Clinical Trial ◽

Cervical Disc Replacement

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P.229 Epidemiology and Outcomes of Neck Pain Following Surgery for Degenerative Cervical Radiculopathy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2021.520 ◽

2021 ◽

Vol 48 (s3) ◽

pp. S86-S86

Author(s):

MA MacLean ◽

A Dakson ◽

F Xavier ◽

SD Christie ◽

C Investigators

Keyword(s):

Neck Pain ◽

Short Form ◽

Neck Disability Index ◽

Cervical Radiculopathy ◽

Research Network ◽

Cervical Disc ◽

Cervical Disc Arthroplasty ◽

Arm Pain ◽

Composite Scale ◽

Neck Disability

Background: Many studies have demonstrated improved arm pain (AP) following surgery for degenerative cervical radiculopathy (DCR); however, axial neck pain (NP) is generally not felt to improve. The purpose of this study was to determine whether surgery for DCR improves NP. Methods: A ambispective cohort study of the Canadian Spine Outcomes Research Network (CSORN) registry for patients who received 1-level, 2-level, 3-level ADCF (anterior cervical discectomy and fusion) or cervical disc arthroplasty (CDA) for DCR. Outcomes: 12-month post-operative Visual Analogue Scale for NP (VAS-NP), Neck Disability Index (NDI), VAS for AP (VAS-AP), Short-Form Physical Health Composite Scale (SF36-PCS), and Mental Health Composite Scale (SF36-MCS). Results: We identified 603 patients with DCR. CDA patients were the youngest (ANOVA; p<0.001). Patients reported similar pre-operative AP, NP, disability, and health-related quality of life, regardless of procedure (ANOVA; all P>0.05). All procedures offered a statistically significant reduction in VAS-NP, VAS-AP, and NDI (ANOVA; all P<0.001). Mean change from baseline in NP, AP, and disability, were similar across procedures. At 12 months, mean reduction in VAS-AP, VAS-NP, and NDI exceeded minimal clinically important differences for nearly all procedures. Conclusions: Patients undergoing surgery for DCR can expect a clinically significant, approximate 50% reduction in NP, AP, and neck-related disability.

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Cervicalgia entre estudantes de medicina: uma realidade multifatorial

Revista da Faculdade de Ciências Médicas de Sorocaba ◽

10.23925/1984-4840.2019v21i2a3 ◽

2019 ◽

Vol 21 (2) ◽

pp. 55-58

Author(s):

Marcos Iae Sato ◽

Luiz Fernando Aguiar ◽

Melissa Nóbrega Vasques de Freitas ◽

Isabella Guerra ◽

José Eduardo Martinez

Keyword(s):

Short Form ◽

Neck Disability Index ◽

Sao Paulo ◽

Medical Outcome Study ◽

Outcome Study ◽

Medical Outcome ◽

Short Form 36 ◽

Sf 36 ◽

Neck Disability ◽

De Medicina

Introdução: A cervicalgia afeta cerca de 50% da população. Predomina em mulheres e se relaciona a esforços repetitivos e má postura. O tempo de estudos e a utilização de livros, computadores e tablets pode gerar posturas inadequadas que podem causar cervicalgia. Objetivo: Conhecer a prevalência dessa afecção nos alunos de medicina da Pontifícia Universidade Católica de São Paulo (PUC-SP) e o respectivo perfil. Materiais e métodos: Foram avaliados cem estudantes de medicina da PUC-SP e aplicados questionários sobre dados demográficos, características clínicas, o Neck Disability Index (NDI) e o Medical Outcome Study Short Form 36 Survey (SF-36). Resultados: A prevalência de cervicalgia foi de 34%, com predomínio feminino. O quadro foi referido como crônico em 16%, enquanto 19% apresentaram apenas 1 episódio. Em relação ao NDI, observa-se que, entre aqueles com 17 a 19 anos, 3 não apresentaram incapacidade e 3 tinham incapacidade leve. De 20 a 22 anos, 6 não apresentaram incapacidade e 12, leve. De 23 a 25 anos, 2 não apresentaram incapacidade, 7 tinham incapacidade leve e 1, moderada. Acima de 26 anos, 1 apresentou incapacidade leve. Houve impacto na qualidade de vida nos domínios aspectos físicos, dor e vitalidade. A análise mostrou que os escores do SF-36 se correlacionam com os valores do NDI, com exceção do domínio aspectos sociais para ambos os sexos e os domínios vitalidade e saúde mental para o sexo masculino. Conclusão: Existe uma prevalência relevante de cervicalgia entre os alunos do curso de medicina da PUC-SP, gerando impacto na qualidade de vida.

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