Fusion around Cervical Disc Prosthesis: Case Report

Abstract OBJECTIVE AND IMPORTANCE: Cervical arthroplasty is a relatively new method to maintain motion after cervical anterior discectomy. Two cases are presented in which bony fusion occurred around a cervical disc prosthesis. CLINICAL PRESENTATION: A 30-year-old man and a 49-year-old woman underwent a right-sided anterior cervical discectomy because of pain in the right arm resulting from a herniated disc (C5–C6). INTERVENTION: A cervical disc prosthesis (Bryan disc prosthesis) was implanted. Postoperatively, the patients were completely free of pain. At the regular 1- and 2-year follow-up examinations, bony fusion was seen on plain x-rays of the cervical spine. The patients were still completely free of signs and symptoms. CONCLUSION: This is the first report in the literature of bony fusion after cervical arthroplasty with the Bryan disc prosthesis.

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Early Clinical and Radiologic Outcomes of Cervical Arthroplasty with Bryan Cervical Disc Prosthesis

Journal of Spinal Disorders & Techniques ◽

10.1097/01.bsd.0000211235.76093.6b ◽

2006 ◽

Vol 19 (7) ◽

pp. 465-470 ◽

Cited By ~ 44

Author(s):

Chan Shik Shim ◽

Sang-Ho Lee ◽

Hyun-Ju Park ◽

Han-Sug Kang ◽

Ji-Hee Hwang

Keyword(s):

Cervical Disc ◽

Disc Prosthesis ◽

Cervical Arthroplasty ◽

Cervical Disc Prosthesis

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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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Cervicothoracic Junction Arthroplasty after Previous Fusion Surgery for Adjacent Segment Degeneration: Case Report

Operative Neurosurgery ◽

10.1227/01.neu.0000144173.35366.55 ◽

2005 ◽

Vol 56 (suppl_1) ◽

pp. ONS-E205-ONS-E205 ◽

Cited By ~ 5

Author(s):

Lali H.S. Sekhon

Keyword(s):

Case Report ◽

Neck Pain ◽

Adjacent Segment Degeneration ◽

Cervical Disc ◽

Adjacent Segment ◽

X Rays ◽

Cervicothoracic Junction ◽

Cervical Arthroplasty ◽

Fusion Surgery ◽

Cervical Disc Prosthesis

Abstract OBJECTIVE AND IMPORTANCE: This is the first reported case of cervical arthroplasty using the Bryan Cervical Disc Prosthesis System (Medtronic Sofamor Danek, Inc., Memphis, TN) in the management of adjacent segment degeneration associated with previous fusion surgery and surgery at the cervicothoracic junction. CLINICAL PRESENTATION: This case report describes a 25-year-old woman who initially underwent a two-level anterior cervical fusion in 1998, 2 years after being involved in a motor vehicle accident. She was well until 18 months before presentation, when she developed bilateral shoulder pain, mechanical neck pain worse on flexion, and bilateral C8 distribution arm pain and paresthesia. On clinical examination, no focal deficits were found, although the range of motion was reduced. Preoperative cervical spine x-rays and magnetic resonance scanning confirmed accelerated degeneration of the C4–C5 and C7–T1 disc spaces, with evidence of neural compression at those levels. INTERVENTION: After careful consideration of various treatment options and failure of all conservative measures, the patient underwent an anterior C4–C5 and C7–T1 decompression with removal of the anterior cervical plate and placement of two artificial disc prostheses. After surgery, her course was uncomplicated and she was discharged from hospital well. There was complete resolution of the arm symptoms and reduction of the neck pain, with a reduction in the amount of analgesia she was taking. Seven months after surgery, she remains well with repeat x-rays confirming motion at the operated levels. CONCLUSION: This case demonstrates that cervical arthroplasty is a reasonable treatment option for patients who have had previous surgery in which interbody fusion has been performed and who have developed degeneration of adjacent levels. Despite the altered biomechanics at the cervicothoracic junction, no adverse features were noted with arthroplasty at this level.

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Cervical arthroplasty with ROTAIO® cervical disc prosthesis: first clinical and radiographic outcome analysis in a multicenter prospective trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-016-0880-7 ◽

2016 ◽

Vol 17 (1) ◽

Cited By ~ 9

Author(s):

J. Obernauer ◽

J. Landscheidt ◽

S. Hartmann ◽

G. A. Schubert ◽

C. Thomé ◽

...

Keyword(s):

Prospective Trial ◽

Cervical Disc ◽

Outcome Analysis ◽

Disc Prosthesis ◽

Radiographic Outcome ◽

Cervical Arthroplasty ◽

Cervical Disc Prosthesis

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Effects of a cervical disc prosthesis on segmental and cervical spine alignment

Neurosurgical FOCUS ◽

10.3171/foc.2004.17.3.5 ◽

2004 ◽

Vol 17 (3) ◽

pp. 1-35 ◽

Cited By ~ 94

Author(s):

Gwynedd E. Pickett ◽

Demytra K. Mitsis ◽

Lali H. Sekhon ◽

William R. Sears ◽

Neil Duggal

Keyword(s):

Cervical Spine ◽

Clinical Outcomes ◽

Sagittal Balance ◽

Cervical Disc ◽

Disc Prosthesis ◽

Disc Space ◽

Cervical Arthroplasty ◽

Sf 36 ◽

Cervical Disc Prosthesis

Object Cervical arthroplasty offers the promise of maintaining motion of the functional spinal unit (FSU) after anterior cervical discectomy. The impact of cervical arthroplasty on sagittal alignment of the FSU needs to be addressed, together with its effect on overall sagittal balance of the cervical spine. Methods The authors prospectively reviewed radiographic and clinical outcomes in 14 patients who received the Bryan Cervical Disc prosthesis (Medtronic Sofamor Danek, Memphis, TN), for whom early (< 6 months) and late (6–24 months) follow-up data were available. Static and dynamic radiographs were measured by hand and computer to determine the angles formed by the endplates of the natural disc preoperatively, those formed by the shells of the implanted prosthesis, the angle of the FSU, and the C2–7 Cobb angle. The range of motion (ROM) was also determined radiographically, whereas clinical outcomes were assessed using the Neck Disability Index (NDI), and Short Form–36 (SF-36) questionnaires. The ROM was preserved following surgery, with a mean preoperative sagittal rotation angle of 8.96°, which was not significantly different from the late postoperative value of 8.25°. When compared with the preoperative disc space angle, the shell endplate angle in the neutral position became kyphotic in the early and late postoperative periods (mean change −3.8° in the late follow-up period; p = 0.0035). The FSU angles also became significantly more kyphotic post-operatively, with a mean change of −6° (p = 0.0006). The Cobb angles varied widely preoperatively and did not change significantly after surgery. There was no statistical correlation between the NDI and SF-36 outcomes and cervical kyphosis. Conclusions Cervical arthroplasty preserves motion of the FSU. Both the endplate angle of the treated disc space and the angle of the FSU became kyphotic after insertion of the Bryan prosthesis. The overall sagittal balance of the cervical spine, however, was preserved.

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