scholarly journals Cervical spine kinematics after anterior cervical discectomy with or without implantation of a mobile cervical disc prosthesis; an RCT

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Toon FM Boselie ◽  
Henk van Mameren ◽  
Rob A de Bie ◽  
Henk van Santbrink
Keyword(s):  
Cervical Spine ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Disc Prosthesis ◽  
Cervical Discectomy ◽  
Spine Kinematics ◽  
Cervical Disc Prosthesis

scholarly journals Evaluation of clinical profile, radiological and functional outcome following anterior cervical discectomy and fusion for cervical compressive myelopathy

2020 ◽  
Vol 7 (8) ◽  
pp. 2679
Author(s):  
Ranjit Kumar ◽  
Brijesh Kumar Tiwari ◽  
Sanjeev Kumar Pandey
Keyword(s):  
Cervical Spine ◽  
Blood Loss ◽  
Surgical Outcome ◽  
Postoperative Outcome ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Cervical Cord ◽  
Cervical Discectomy ◽  
Cervical Compressive Myelopathy ◽  
Compressive Myelopathy

Background: Symptomatic cervical disc prolapse is best managed with anterior cervical discectomy with or without fusion. We studied the clinical, radiological and surgical profile with postoperative outcome of the patients undergoing anterior cervical discectomy and fusion (ACDF) for cervical compressive myelopathy at one level.Methods: In this retrospective study, data was collected from patients who underwent ACDF for cervical compressive myelopathy in our hospital between 2016 and 2019. Clinical, radiological profile with surgical outcome were studied.Results: A total of 283 patients were recruited. They could be followed up for a period of at least 6 months and so were recruited for the study. Out of these 283 patients (201 males; 82 females; mean age, 48.4 years, range, 22 years to 83 years), magnetic resonance imaging (MRI) cervical spine without contrast and x-ray cervical spine was available for all the patients. Nape of neck pain was the most common presenting symptom followed by tingling sensation in all four limbs and trunk. Average time taken for surgery was 2 hours 10 minutes with an average blood loss of 50 ml. Mean follow up duration was 2.7 years (range 6 months to 4 years).Conclusions: ACDF is the treatment of choice for the patients with clinical and radiological evidence of cervical cord compression. The techniques is associated with minimal blood loss and exceptionally good surgical outcome. Following discectomy, putting an autologous graft or titanium cage improves the spine stability and maintains the cervical lordosis.

scholarly journals Artificial Disc Insertion Following Anterior Cervical Discectomy

2003 ◽  
Vol 30 (3) ◽  
pp. 278-283 ◽  
Author(s):  
Gwynedd E. Pickett ◽  
Neil Duggal
Keyword(s):  
Disc Herniation ◽  
Symptomatic Relief ◽  
Clinical Results ◽  
Anterior Cervical Discectomy ◽  
Cervical Disc ◽  
Complete Relief ◽  
Adjacent Segment ◽  
Cervical Discectomy ◽  
Functional Spinal Unit ◽  
Cervical Disc Prosthesis

Objective and importance:Fusion following anterior cervical discectomy has been implicated in the acceleration of degenerative changes in the adjacent spinal segments. Discectomy followed by implantation of an artificial cervical disc maintains the functionality of the spinal unit, while still providing excellent symptomatic relief. We describe our preliminary experience with implantation of the Bryan Cervical Disc System in two cases of single-level cervical disc herniation.Clinical presentation:Two male patients presented with a left C6 radiculopathy, without evidence of myelopathy. Magnetic resonance imaging revealed a disc herniation at C5-6 in both cases. Pre-operative flexion and extension radiographs demonstrated preserved motion at the involved levels.Intervention/technique:Following a standard anterior cervical decompression, precision drilling of the vertebral endplates was carried out using a drill attached to a bed-mounted, gravitationally-referenced retraction frame. An artificial cervical disc, composed of a polyurethane nucleus with titanium endplates, was fitted between the contoured endplates without fixation to the vertebral bodies. No complications were experienced during the insertion of the prosthesis, or in the postoperative course. Both patients experienced immediate postoperative resolution of their radicular pain and were discharged from hospital the following day. At nine months following surgery, both patients continue to have complete relief of radicular symptoms. Postoperative radiographs at six months following surgery confirm accurate placement of the prosthesis and preserved mobility of the functional spinal unit.Conclusion:Insertion of the Bryan artificial cervical disc prosthesis following anterior cervical discectomy is a relatively straightforward procedure, which appears to be safe and provides good clinical results, without requiring additional surgical time. Long-term follow-up is required to assess its safety, efficacy, and ability to prevent adjacent segment degeneration.

scholarly journals Comparative study of anterior cervical discectomy and fusion by anterior cervical plate and stand-alone cervical cage

2020 ◽  
Vol 6 (5) ◽  
pp. 888
Author(s):  
Ansari Muqtadeer Abdul Aziz ◽  
Venktesh Dattatray Sonkawade ◽  
Ansari Ishtyaque Abdul Aziz ◽  
Nair Pradeepkumar Sasidharan
Keyword(s):  
Cervical Spine ◽  
Intraoperative Complications ◽  
Anterior Cervical Discectomy ◽  
Research Centre ◽  
Cervical Disc ◽  
Cervical Discectomy ◽  
Single Level ◽  
Incision Size ◽  
Cervical Plate ◽  
Anterior Cervical Plate

<p class="abstract"><strong>Background:</strong> Anterior cervical discectomy (ACD) was used for management of degenerative cervical disc disorders (DCDD) in previous days. Further research and developments in management of DCDD led to evolution of standard and widely used operative technique as anterior cervical discectomy and fusion (ACDF) by either anterior cervical plate (ACDF-ACP) with bone grafting or stand-alone cage (ACDF-SAC). There is less data available in literature regarding when and where to use ACDF-ACP and ACDF-SAC.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on 20 patients operated in Government Medical College and Hospital and Pacific Hospital and Research Centre, Aurangabad from June 2018 to March 2020. These patients divided into group A - 10 patients, operated by ACDF-SAC which are further divided as group Aa - 6 patients - operated for single level ACDF-SAC and group Ab - 4 patients - operated for two level ACDF-SAC, group B - 10 patients, operated by ACDF-ACP which are further divided as group Ba - 5 patients - operated for single level ACDF-ACP and group Bb - 5 patients - operated for two level ACDF-ACP. Patients evaluated preoperatively and postoperatively using X-ray cervical spine anteroposterior (AP) and lateral views, MRI cervical spine, visual analogue scale (VAS) for pain, Robinson’s criteria and Cobb’s angle.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study we found, ACDF-SAC has small incision size, less intraoperative time, easy to carry out for surgeons, less intraoperative complications and better clinical outcome as compared to ACDF-ACP. Whereas only radiological results were better in ACDF-ACP than ACDF-SAC.</p><p class="abstract"><strong>Conclusions:</strong> ACDF-SAC is superior to ACDF-ACP for appropriately selected patients and in well experienced hands.</p>

In vitro evaluation of a ball-and-socket cervical disc prosthesis with cranial geometric center

2009 ◽  
Vol 11 (5) ◽  
pp. 538-546 ◽  
Author(s):  
Cédric Barrey ◽  
Thomas Mosnier ◽  
Jérôme Jund ◽  
Gilles Perrin ◽  
Wafa Skalli
Keyword(s):  
Cervical Spine ◽  
Axial Rotation ◽  
Cervical Disc ◽  
Disc Prosthesis ◽  
Lateral Bending ◽  
Flexion Extension ◽  
Cervical Disc Prosthesis ◽  
Before And After ◽  
Left And Right

Object Few biomechanical in vitro studies have reported the effects of disc replacement on motion and kinematics of the cervical spine. The purpose of this study was to analyze motion through 3D load-displacement curves before and after implantation of a ball-and-socket cervical disc prosthesis with cranial geometric center; special focus was placed on coupled motion, which is a well-known aspect of normal cervical spine kinematics. Methods Six human cervical spines were studied. There were 3 male and 3 female cadaveric specimens (mean age at death 68.5 ± 5 years [range 54–74 years]). The specimens were evaluated sequentially in 2 different conditions: first they were tested intact; then the spinal specimens were tested after implantation of a ball-and-socket cervical disc prosthesis, the Discocerv, at the C5–6 level. Pure moment loading was applied in flexion/extension, left and right axial rotation, and left and right lateral bending. All tests were performed under load control with a 3D measurement system. Results No differences were found to be statistically significant after comparison of range of motion between intact and instrumented spines for all loading conditions. The mean range of motion for intact spines was 10.3° in flexion/extension, 5.6° in lateral bending, and 5.4° in axial rotation; that for instrumented spines was 10.4, 5.2, and 4.8°, respectively. No statistical difference was observed for the neutral zone nor stiffness between intact and instrumented spines. Finally, the coupled motions were also preserved during axial rotation and lateral bending, with no significant difference before and after implantation. Conclusions This study demonstrated that, under specific testing conditions, a ball-and-socket joint with cranial geometrical center can restore motion in the 3 planes after discectomy in the cervical spine while maintaining physiological coupled motions during axial rotation and lateral bending.

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