Analysis of in vivo kinematics of 3 different cervical devices: Bryan disc, ProDisc-C, and Prestige LP disc

2011 ◽  
Vol 15 (6) ◽  
pp. 630-635 ◽  
Author(s):  
Izabela Kowalczyk ◽  
Bruno C. R. Lazaro ◽  
Marie Fink ◽  
Doron Rabin ◽  
Neil Duggal
Keyword(s):  
Cervical Spine ◽  
Sagittal Balance ◽  
Adjacent Segment ◽  
Cervical Arthroplasty ◽  
Measurement Analysis ◽  
Bryan Disc ◽  
Index Level ◽  
The Impact ◽  
The Prestige

Object Cervical arthroplasty has emerged as a means of preventing adjacent segment disease by preserving motion, restoring sagittal balance, and mimicking natural spinal kinematics. The purpose of this retrospective in vivo study was to characterize the impact of arthroplasty on sagittal balance and segmental kinematics of the cervical spine. Methods Sixty patients receiving the Bryan disc, ProDisc-C, or Prestige LP disc were retrospectively analyzed. Only single-level arthroplasty cases were included in this study. Lateral dynamic radiographs of the cervical spine were evaluated using quantitative measurement analysis software to determine the kinematics at the index level both preoperatively and 1 year postoperatively. Collected parameters included range of motion (ROM), disc angles, shell angles, anterior and posterior disc heights (ADHs/PDHs), translation, and center of rotation (COR). Preoperative and postoperative data were compared using the Student t-test, with p < 0.05 indicating significance. Results The Bryan and Prestige LP discs preserved motion, whereas the ProDisc-C increased segmental ROM from extension to flexion. Following surgery, the Bryan disc exhibited significant shell angle kyphosis, while ProDisc-C and Prestige LP retained lordosis. Both ADHs and PDHs decreased following insertion of the Bryan disc. In contrast, the ProDisc-C increased the ADHs and PDHs by 80% and 52%, respectively, and the Prestige LP disc increased the ADHs and PDHs by 20%. Only the ProDisc-C demonstrated significant translation of 0.7 mm. The ProDisc-C shifted the COR x by 0.9 mm anteriorly, while the Prestige LP disc demonstrated a significant superior shift of 2.2 mm in COR y. Conclusions All discs adequately maintained ROM at the surgical level. The greatest difference among the 3 devices was in the disc height and index angle measurements.

Radiological changes of the operated and adjacent segments following cervical arthroplasty after a minimum 24-month follow-up: comparison between the Bryan and Prodisc-C devices

2010 ◽  
Vol 13 (3) ◽  
pp. 299-307 ◽  
Author(s):  
Kyeong-Sik Ryu ◽  
Chun-Kun Park ◽  
Sung-Chul Jun ◽  
Han-Yong Huh
Keyword(s):  
Clinical Outcome ◽  
Range Of Motion ◽  
Posterior Longitudinal Ligament ◽  
Occurrence Rate ◽  
Cervical Arthroplasty ◽  
Functional Spinal Unit ◽  
Bryan Disc ◽  
Radiological Changes ◽  
Index Level

Object The purposes of this retrospective study were to determine the radiological changes at the index and adjacent levels after cervical arthroplasty using the Bryan disc and Prodisc-C disc after a minimum 24 months follow-up, and to demonstrate the possible clinical factors related to these changes. Methods Following single-level cervical arthroplasty using either the Bryan disc or Prodisc-C, the degree of facet degeneration and other radiological changes at the index and adjacent levels were assessed by observing radiographs and CT scans at a minimum 24 months after the operations. These findings were determined in relation to the clinical outcome, various perioperative factors, and prosthesis factors. Thirty-six patients were included in this investigation (19 in the Bryan disc group and 17 in the Prodisc-C group). Results At the index level, progression of facet arthrosis (PFA) was observed in 7 of 36 levels (1 level with the Bryan disc, 6 with the Prodisc-C). At adjacent levels, PFA was minimally observed. Heterotopic ossification (HO) was observed at 19 levels (11 with the Bryan disc, 8 with Prodisc-C). Progression of facet arthrosis at the index segments was positively related to malposition of the prosthesis on the frontal plane, and decreased postoperative functional spinal unit range of motion at the index level. Occurrence of HO was correlated with the preoperative calcification of the posterior longitudinal ligament at the operated level, regardless of prosthesis type. Clinical outcome and the occurrence of PFA or HO did not show any significant relationship. Conclusions This study demonstrates that the incidence of PFA at the index level is 19.4% after a minimum 24-month follow-up, and occurs more frequently in the Prodisc-C group. Progression of facet arthrosis is related to less functional spinal unit range of motion and anterior placement of the prosthesis. The occurrence rate of HO is high, regardless of the type of prosthesis, and it is significantly correlated with preoperative calcification of the posterior longitudinal ligament at the operated level.

scholarly journals Assessment of spino cranial angle of cervical spine sagittal balance system after multi-level anterior cervical discectomy and fusion

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zheng Wang ◽  
Zhi-Wei Wang ◽  
Xi-Wen Fan ◽  
Xian-Da Gao ◽  
Wen-Yuan Ding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cervical Spine ◽  
Sagittal Balance ◽  
Anterior Cervical Discectomy ◽  
Operating Characteristics ◽  
Cervical Discectomy ◽  
Multi Level ◽  
The Impact

Abstract Background To analyze the impact of spino cranial angle (SCA) on alteration of cervical alignment after multi-level anterior cervical discectomy fusion (ACDF) and explore the relationship between SCA and health-related quality of life (HRQOL) scores. Material and methods In total, 49 patients following multi-level ACDF for multi-level cervical spondylotic myelopathy (MCSM) with more than 2 years follow-up period were enrolled. Radiographic data including SCA were measured. Receiver operating characteristics (ROC) curve analysis was applied to confirm the optimal cut-off values of SCA for predicting sagittal balance. Patients were divided into two groups on the basis of the cut-off value of preoperative SCA. Correlation coefficients were analyzed between SCA and HRQOL scores. Results Optimal cut-off values for predicting sagittal balance was SCA of 88.6°. Patients with higher SCA, no matter preoperatively, postoperatively and at follow-up, got lower T1-Slope (T1s), C2–C7 lordosis angle (CA) and higher △SCA (pre vs post: p = 0.036, pre vs F/U: p = 0.022). Simultaneously, pre-SCA, post-SCA, and F/U-SCA in the high SCA group were positively correlated with the pre-NDI, post-NDI, and F/U-NDI scores respectively (pre: p < 0.001, post: p = 0.015, F/U: p = 0.003). However, no correlation was performed in the low SCA group. Conclusion An excessive SCA can be considered to cause poorer clinical outcomes at preoperative and better correction after surgery. The SCA could be used as a new reference value to determine sagittal balance parameters of the cervical spine and to assess the quality of life.

Artificial Disc Versus Fusion: Effect on Three-Dimensional Dynamic In Vivo Cervical Spine Motion

2011 ◽  
Author(s):  
Colin P. McDonald ◽  
Michael J. McDonald ◽  
Nicole L. Ramo ◽  
Stephen W. Bartol ◽  
Michael J. Bey
Keyword(s):  
Cervical Spine ◽  
Three Dimensional ◽  
Adjacent Segment Degeneration ◽  
Cervical Disc ◽  
Adjacent Segment ◽  
Artificial Disc ◽  
Disc Disease ◽  
Adjacent Disc ◽  
Spine Motion

Intervertebral disc degeneration in the cervical spine is a common condition that often manifests as cervical disc disease, resulting in pain, motor weakness and sensory deficits. The most common surgical treatment strategy involves removal of the diseased disc and fusion of the adjacent vertebrae. Although fusion typically relieves symptoms at the surgical site, evidence of degeneration in the adjacent disc has been reported in 25–92% of patients [1,2]. It has been hypothesized that the progression of adjacent segment degeneration is a result of increased motion at the segments adjacent to the site of fusion [3]. As a response to this proposed mechanism of degeneration, artificial discs were designed with the goals of preserving motion at the operative site and maintaining normal motion in the adjacent segments. However, the extent to which normal adjacent segment motion is maintained in artificial disc patients compared to fusion patients remains unknown. Thus, the objective of this study was to compare the dynamic, three-dimensional (3D) motion of the cervical spine in fusion patients and artificial disc replacement patients.

scholarly journals Association between sagittal balance and adjacent segment degeneration in anterior cervical surgery: a systematic review and meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yijian Zhang ◽  
Yijie Shao ◽  
Hao Liu ◽  
Junxin Zhang ◽  
Fan He ◽  
...  
Keyword(s):  
Sagittal Balance ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Adjacent Segment Degeneration ◽  
Cochrane Library ◽  
Adjacent Segment ◽  
Primary Surgery ◽  
Cervical Surgery ◽  
Anterior Cervical Surgery ◽  
The Impact

Abstract Background ASD is a relatively common degenerative alteration after cervical surgery which occurs above or below the fused segment. In addition, some patients may need reoperation to treat severe ASD after the primary surgery. It was considered that sagittal balance is correlated with postoperative clinical outcomes; however, few studies have reported the influence of sagittal balance on ASD. The present study is designed to investigate whether sagittal balance impacts the pathology of adjacent segment disease (ASD) in patients who undergo anterior cervical surgery for degenerative cervical disease. Methods Databases including Pubmed, Embase, Cochrane library, and Web of Science were used to search for literature published before June 2018. Review Manager 5.3 was used to perform the statistical analysis. Sagittal balance parameters before and after surgery were compared between patients with and without ASD. Weighted mean difference (WMD) was summarized for continuous data and P < 0.05 was set for the level of significance. Results A total of 221 patients with ASD and 680 patients without ASD from seven articles were studied in this meta-analysis. There were no significant differences in most sagittal balance parameters between the two groups, except for postoperative cervical lordosis (CL) (WMD -3.30, CI -5.91, − 0.69, P = 0.01). Conclusions Some sagittal balance parameters may be associated with the development of ASD after anterior cervical surgery. Sufficient restoration of CL may decrease the incidence of ASD. The results in present study needed to be expanded carefully and further high-quality studies are warranted to investigate the impact of sagittal balance on ASD.

scholarly journals Biomechanical Study of Cervical Disc Arthroplasty Devices Using Finite Element Modeling

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Narayan Yoganandan ◽  
Yuvaraj Purushothaman ◽  
Hoon Choi ◽  
Jamie Baisden ◽  
Deepak Rajasekaran ◽  
...  
Keyword(s):  
Finite Element ◽  
Intradiscal Pressure ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Lateral Bending ◽  
Disc Arthroplasty ◽  
Bryan Disc ◽  
Flexion Extension ◽  
Index Level

Abstract Many artificial discs for have been introduced to overcome the disadvantages of conventional anterior discectomy and fusion. The purpose of this study was to evaluate the performance of different U.S. Food and Drug Administration (FDA)-approved cervical disc arthroplasty (CDA) on the range of motion (ROM), intradiscal pressure, and facet force variables under physiological loading. A validated three-dimensional finite element model of the human intact cervical spine (C2-T1) was used. The intact spine was modified to simulate CDAs at C5-C6. Hybrid loading with a follower load of 75 N and moments under flexion, extension, and lateral bending of 2 N·m each were applied to intact and CDA spines. From this work, it was found that at the index level, all CDAs except the Bryan disc increased ROM, and at the adjacent levels, motion decreased in all modes. The largest increase occurred under the lateral bending mode. The Bryan disc had compensatory motion increases at the adjacent levels. Intradiscal pressure reduced at the adjacent levels with Mobi-C and Secure-C. Facet force increased at the index level in all CDAs, with the highest force with the Mobi-C. The force generally decreased at the adjacent levels, except for the Bryan disc and Prestige LP in lateral bending. This study demonstrates the influence of different CDA designs on the anterior and posterior loading patterns at the index and adjacent levels with head supported mass type loadings. The study validates key clinical observations: CDA procedure is contraindicated in cases of facet arthroplasty and may be protective against adjacent segment degeneration.

scholarly journals Comparative Finite Element Modeling Study of Anterior Cervical Arthrodesis Versus Cervical Arthroplasty With Bryan Disc or Prodisc C

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 737-744
Author(s):  
Hoon Choi ◽  
Yuvaraj Purushothaman ◽  
Jamie L Baisden ◽  
Deepak Rajasekaran ◽  
Davidson Jebaseelan ◽  
...  
Keyword(s):  
Finite Element ◽  
Intradiscal Pressure ◽  
Implant Design ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Pathological State ◽  
Cervical Arthroplasty ◽  
Bryan Disc ◽  
Flexion Extension ◽  
Index Level

ABSTRACT Introduction Cervical disc arthroplasty (CDA), a motion-preserving alternative to anterior cervical discectomy and fusion (ACDF), is used in military patients for the treatment of disorders such as spondylosis. Since 2007, the FDA has approved eight artificial discs. The objective of this study is to compare the biomechanics after ACDF and CDA with two FDA-approved devices of differing designs under head and head supported mass loadings. Materials and Methods A previously validated osteoligamentous C2-T1 finite element model was used to simulate ACDF and two types of CDA (Bryan and Prodisc C) at the C5-C6 level. The hybrid loading protocol associated with in vivo head and head supported mass was used to apply flexion and extension loading. First, intact spine was subjected to 2 Nm of flexion extension and the range of motion (ROM) was measured. Next, for each surgical option, flexion-extension moments duplicating the same ROM as the intact spine were determined. Under these surgery-specific moments, ROM and facet force were obtained at the index level, and ROM, facet force, and intradiscal pressure at the rostral and caudal adjacent levels. Results ACDF led to increased motion, force and pressures at the adjacent levels. Prodisc C led to increased motion and facet force at the index level, and decreased motion, facet force, and intradiscal pressure at both adjacent levels. Bryan produced less dramatic biomechanical alterations compared with ACDF and Prodisc C. Numerical results are given in the article. Conclusions Recognizing that ROM is a clinical measure of spine stability/performance, CDA demonstrates a more physiological biomechanical response than ACDF, although the exact pattern depends on the implant design. Anterior and posterior column load-sharing patterns were different between the two implants and may affect implant selection based on the anatomical and pathological state at the index and adjacent levels.

scholarly journals Effect of arthroplasty design on cervical spine kinematics: analysis of the Bryan Disc, ProDisc-C, and Synergy Disc

2010 ◽  
Vol 28 (6) ◽  
pp. E6 ◽  
Author(s):  
Bruno C. R. Lazaro ◽  
Kemal Yucesoy ◽  
Kasim Z. Yuksel ◽  
Izabela Kowalczyk ◽  
Doron Rabin ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Total Disc Replacement ◽  
Adjacent Segment Disease ◽  
Cervical Disc ◽  
Adjacent Segment ◽  
Disc Space ◽  
Center Of Rotation ◽  
Significance Level ◽  
Bryan Disc

Object Cervical total disc replacement has emerged as a surgical option to preserve motion and potentially avoid adjacent-segment disease after anterior cervical discectomy and fusion. Recently, much attention has been directed at the ability of a given device to maintain and/or restore normal segmental alignment. Nonphysiological disc and segmental angulation could result in increased stresses transmitted to the facet joints and posterior elements, conflicting with the essence of arthroplasty and potentially leading to adjacent-segment disease. The goal of this study was to contrast device alignment and segmental kinematics provided by 3 different cervical disc prostheses. Methods Sixty patients were retrospectively analyzed and divided into 3 groups receiving the Bryan, ProDisc-C, or Synergy disc. Only single-level arthroplasty cases were included in the study. Lateral dynamic radiographs of the cervical spine were analyzed using quantitative motion analysis software (Medical Metrics, Inc.) to analyze the kinematics at the index level both preoperatively and postoperatively. Several parameters were noted, including range of motion, disc angles, shell angles, anterior and posterior disc heights, translation, and center of rotation. Preoperative and postoperative data were compared using the Student t-test with a significance level of p < 0.05. Results Postoperatively, all 3 disc groups maintained adequate range of motion at the implanted level. With respect to the shell angles, the Synergy disc demonstrated the least variability, maintaining 6° lordotic configuration between the device endplates. In the Bryan disc group, significant shell kyphosis developed postoperatively (p < 0.0001). Both ProDisc-C and Synergy discs significantly increased anterior and posterior disc heights (p < 0.0001). The Bryan and Synergy discs maintained the natural center of rotation, whereas significant anterior shift occurred with ProDisc-C. Conclusions The goal for motion preservation at the implanted level was achieved using all 3 devices. The Synergy disc was unique in its ability to alter device angulation by 6°. The Bryan disc demonstrated device endplate kyphosis. Both the Synergy disc and ProDisc-C increased disc space height.

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

2004 ◽  
Vol 17 (3) ◽  
pp. 1-35 ◽  
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.

scholarly journals History of cervical disc arthroplasty

2009 ◽  
Vol 27 (3) ◽  
pp. E10 ◽  
Author(s):  
Ali A. Baaj ◽  
Juan S. Uribe ◽  
Fernando L. Vale ◽  
Mark C. Preul ◽  
Neil R. Crawford
Keyword(s):  
Cervical Spine ◽  
Load Transfer ◽  
The Other ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Adjacent Segment ◽  
Cervical Arthroplasty ◽  
Disc Arthroplasty ◽  
History Of ◽  
Adjacent Segments

Enthusiasm for cervical disc arthroplasty is based on the premise that motion-preserving devices attenuate the progression of adjacent-segment disease (ASD) in the cervical spine. Arthrodesis, on the other hand, results in abnormal load transfer on adjacent segments, leading to the acceleration of ASD. It has taken several decades of pioneering work to produce clinically relevant devices that mimic the kinematics of the intervertebral disc. The goal of this work is to trace the origins of cervical arthroplasty technology and highlight the attributes of devices currently available in the market.

Experimental Study of the Impact of Alisma plantago-aquatica Secretions on Pathogenic Bacteria

2014 ◽  
Vol 1 (3) ◽  
pp. 3-7
Author(s):  
O. Zhukorskyy ◽  
O. Hulay
Keyword(s):  
Pathogenic Bacteria ◽  
Initial Density ◽  
Biologically Active ◽  
Erysipelothrix Rhusiopathiae ◽  
Natural Focus ◽  
Test Species ◽  
Popula Tions ◽  
And Control ◽  
The Impact

Aim. To estimate the impact of in vivo secretions of water plantain (Alisma plantago-aquatica) on the popula- tions of pathogenic bacteria Erysipelothrix rhusiopathiae. Methods. The plants were isolated from their natural conditions, the roots were washed from the substrate residues and cultivated in laboratory conditions for 10 days to heal the damage. Then the water was changed; seven days later the selected samples were sterilized using fi lters with 0.2 μm pore diameter. The dilution of water plantain root diffusates in the experimental samples was 1:10–1:10,000. The initial density of E. rhusiopathiae bacteria populations was the same for both experimental and control samples. The estimation of the results was conducted 48 hours later. Results. When the dilution of root diffusates was 1:10, the density of erysipelothrixes in the experimental samples was 11.26 times higher than that of the control, on average, the dilution of 1:100 − 6.16 times higher, 1:1000 – 3.22 times higher, 1:10,000 – 1.81 times higher, respectively. Conclusions. The plants of A. plantago-aquatica species are capable of affecting the populations of E. rhusiopathiae pathogenic bacteria via the secretion of biologically active substances into the environment. The consequences of this interaction are positive for the abovementioned bacteria, which is demon- strated by the increase in the density of their populations in the experiment compared to the control. The intensity of the stimulating effect on the populations of E. rhusiopathiae in the root diffusates of A. plantago-aquatica is re- ciprocally dependent on the degree of their dilution. The investigated impact of water plantain on erysipelothrixes should be related to the topical type of biocenotic connections, the formation of which between the test species in the ecosystems might promote maintaining the potential of natural focus of rabies. Keywords: Alisma plantago-aquatica, in vivo secretions, Erysipelothrix rhusiopathiae, population density, topical type of connections.

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