Cervical Disc Arthroplasty -Efficacy and Indications. Single Center Long-Term Cohort Study Compared to Rcts’ Results

OBJECTIVEThe objective of this study was to identify the risk factors of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and the subsequent effect of this phenomenon.METHODSThe authors performed a retrospective radiological review of 185 patients with a minimum 5-year follow-up after CDA (using Bryan, Discocerv, Mobi-C, or Baguera C). Postoperative radiographs were examined and compared to the initial postoperative films to determine the percentage of ABL. The relationship of ABL to potential risk factors was analyzed.RESULTSComplete radiological assessment was available in 145 patients with 193 CDRs and 383 endplates (average age 45 years, range 25–65 years, 54% women). ABL was identified in 63.7% of CDRs (48.7% mild, 11.9% moderate, 3.1% severe). Age (p = 0.770), sex (p = 0.200), postoperative alignment (p = 0.330), midflexion point (p = 0.509), maximal flexion (p = 0.080), and extension (p = 0.717) did not relate to ABL. There was no significant difference in the rate of severe ABL between implants. Multilevel surgery conferred an increased risk of any and severe ABL (p = 0.013 for both). The upper endplate, defined as superior to the CDA, was more commonly involved (p = 0.008), but there was no significant difference whether the endplate was between or not between implants (p = 0.226). The development of ABL did not affect the long-term range of movement (ROM) of the CDA, but did increase the overall risk of autofusion. ABL was not associated with pain or functional deficits. No patients required a reoperation or revision of their implant during the course of this study, and there were no cases of progressive ABL beyond the first year.CONCLUSIONSABL is common in all implant types assessed, although most is mild. Age, sex, postoperative alignment, ROM, and midflexion point do not relate to this phenomenon. However, the greater the number of levels operated, the higher the risk of developing ABL. The development of ABL has no long-term effect on the mechanical functioning of the disc or necessity for revision surgery, although it may increase the rate of autofusion.

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Long-Term Societal Costs of Anterior Cervical Discectomy and Fusion versus Cervical Disc Arthroplasty for the Treatment of Single-Level Cervical Disc Disease

The Spine Journal ◽

10.1016/j.spinee.2014.08.064 ◽

2014 ◽

Vol 14 (11) ◽

pp. S23 ◽

Cited By ~ 1

Author(s):

Ahmer K. Ghori

Keyword(s):

Anterior Cervical Discectomy ◽

Cervical Disc ◽

Cervical Disc Arthroplasty ◽

Cervical Disc Disease ◽

Disc Disease ◽

Societal Costs ◽

Disc Arthroplasty ◽

Cervical Discectomy ◽

Single Level

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Outcomes of Single-Level Cervical Disc Arthroplasty versus Anterior Discectomy and Fusion: A Single Center, Retrospective Review

The Spine Journal ◽

10.1016/j.spinee.2013.07.042 ◽

2013 ◽

Vol 13 (9) ◽

pp. S5

Author(s):

Ronald A. Lehman ◽

Robert W. Tracey ◽

John P. Cody ◽

Daniel G. Kang ◽

Adam Bevevino ◽

...

Keyword(s):

Retrospective Review ◽

Cervical Disc ◽

Cervical Disc Arthroplasty ◽

Single Center ◽

Disc Arthroplasty ◽

Single Level ◽

Anterior Discectomy ◽

Anterior Discectomy And Fusion

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Postoperative MRI Visualization of the Cervical Spine Following Cervical Disc Arthroplasty: A Prospective Single-Center Comparison of a Titanium and Cobalt-Chromium Prosthesis

Global Spine Journal ◽

10.1177/2192568221991105 ◽

2021 ◽

pp. 219256822199110

Author(s):

Vadim A. Byvaltsev ◽

Andrei A. Kalinin ◽

Marat A. Aliyev ◽

K. Daniel Riew

Keyword(s):

Observer Agreement ◽

Cervical Disc ◽

Cervical Disc Arthroplasty ◽

Single Center ◽

Cobalt Chromium ◽

Significant Deterioration ◽

Disc Arthroplasty ◽

Jarvik 2000 ◽

Total Arthroplasty

Study Design: Prospective non-randomized single-center cohort study. Objectives: To analyze the quality of postoperative magnetic resonance imaging of 2 structurally different cervical disc arthroplasty devices at the index and adjacent levels. Methods: A non-randomized, comparative, prospective, single-center study included 40 patients (23 men and 17 women) aged 32 (26-40) years. Two study groups were utilized: in the first (n = 20), a titanium prosthesis was used; in the second (n = 20), a cobalt-chromium implant was used. Evaluation of MRI studies before and after surgery was performed using sagittal and axial T2 weighted images by 2 specialists who were blinded to the prosthesis that was used. To determine the quality of an MRI image, the classification of Jarvik 2000, the radiological and orthopedic scales for assessing artifacts were used. Results: There was good-to-excellent inter-observer agreement for all of the MR parameters used for the titanium and satisfactory-to-good for the cobalt chromium group. The analysis of the quality of postoperative imaging using the Jarvik 2000 scale showed a statistically significant deterioration in MR images in the cobalt chromium group ( P < 0.001), compared to the titanium ( P = 0.091). Following a single-level total arthroplasty, the titanium group had better MRI images according to radiological and orthopedic scales ( P < 0.001). Conclusion: Titanium cervical disc arthroplasty devices result in superior postoperative MR imaging, as compared to cobalt chromium prostheses, as the latter significantly reduces image quality due to the pronounced ferromagnetic effect.

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