Cervical anterior hybrid technique with bi-level Bryan artificial disc replacement and adjacent segment fusion for cervical myelopathy over three consecutive segments

Chen, Jiang; Lin, Xu; Jia, Yu-Song; Sun, Qi; Li, Jinyu; Zheng, Chenying; Bai, Chunxiao; Yu, Qinsheng

doi:10.1016/j.jocn.2015.07.030

Cited by 19 publications

(6 citation statements)

References 16 publications

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“…This might be explained by the intervertebral distractive effect of Prodisc-C, which could distribute the stress of facet joints [2]. Recent studies showed that hybrid surgery (HS), which incorporated CDA at the mobile segment with ACDF at the spondylotic segment, could preserve the mobility of cervical spine to produce satisfactory clinical outcomes and reducing ASD [10,11,[36][37][38]. Considering multilevel CDDD can have different degenerative status at each level, HS may not always be appropriate to treat this kind of disease [12].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Sun

Zhang

et al. 2020

J Orthop Surg Res

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Background: Biomechanical characteristics of noncontinuous ACDF and noncontinuous CDA in the treatment of noncontinuous cervical degenerative disc disease were still unclear. The aim of this research is to compare the differences between these two kinds of treatment methods and to verify the effectiveness of Prodisc-C in noncontinuous CDA. Methods: Eight FEMs of the cervical spine (C2-C7) were built based on CT images of 8 mild CDDD volunteers. In the arthroplasty group, we inserted Prodisc-C at C3/4 and C5/6. In the fusion group, CoRoent® Contour and NuVasive® Helix ACP were implanted at C3/4 and C5/6. Initial loads of 75 N were used to simulate the head weight and muscle forces. The application of 1.0 N m moment on the top on the C2 vertebra was used to create motion in all directions. Statistical analyses were performed using STATA version 14.0 (Stata Corp LP, College Station, Texas, USA). Statistical significance was set at P < 0.05. Results: The IDPs in C2/3 (P < 0.001, P = 0.005, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the intact group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. In addition, the IDPs in C2/3 (P < 0.001, P = 0.001, P < 0.001, P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) of the arthroplasty group were significantly less than that in the fusion group in flexion, extension, lateral bending, and axial rotation, respectively. Contact forces of facet joints in C2/3 (P = 0.010) in the arthroplasty group was significantly less than that in the intact group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the arthroplasty group was significantly less than that in the fusion group. Contact forces of facet joints in C2/3 (P < 0.001), C4/5 (P < 0.001), and C6/7 (P < 0.001) in the intact group were significantly less than that in the fusion group.

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Section: Discussionmentioning

confidence: 99%

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Sun

Zhang

et al. 2020

J Orthop Surg Res

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“…[1–4] However, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical endplates. [5] Furthermore, clinical outcomes have been reported for several complications related to size mismatch between the anatomic parameters of the cervical vertebrae and the footprint of the disc prostheses such as subsidence and heterotopic ossification.…”

Section: Introductionmentioning

confidence: 99%

A morphometric study of the middle and lower cervical vertebral endplates and their components

Feng

Fang²,

Huang³

et al. 2017

Medicine

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Cervical disc arthroplasty is a common method of treating cervical degenerative disease. However, the footprints of most prosthesis dimensions are obtained from data of Caucasian individuals. Besides, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical endplates. We aimed to detail the three-dimensional (3D) anatomic morphology of the subaxial cervical vertebral endplate, utilizing high-precision, high-resolution scanning equipment, and provide a theoretical basis for designing appropriate disc prostheses for Chinese patients.A total of 138 cervical vertebral endplates were studied. Each endplate was digitized using a non-contact optical 3D range scanning system and then reconstructed to quantify diameters and surface area for the whole endplate and its components (central endplate and epiphyseal rim). The whole endplate and mid-plane concavity depth were measured.There is marked morphologic asymmetry, in that the cranial endplate is more concave than the corresponding caudal endplate, with endplate concavity depths of 2.04 and 0.69 mm, respectively. For the caudal endplates, the endplate concavity apex locations were always located in the posterior portion (81.42%), while in cranial endplates relatively even. The central endplate was approximately 60% of the area of the whole endplate and the anterior section of the ring was the widest. From C3/4 down to C6/7 discs, the vertebral endplate gradually became more elliptical. Chinese cervical endplate anatomic sizes are generally smaller than that of Caucasians. Although Korean and Chinese individuals both belong to the Asian population subgroup, the majority of anatomic dimensions differ. Singaporean cervical endplate morphology is very similar to that of Chinese patients.We performed a comprehensive and accurate quantitative description of the cervical endplate, which provide references to shape and profile an artificial cervical disc without sacrificing valuable bone stock. To design a device with footprint as large as possible to distribute the axial load, we suggest that additional attention should be paid to the marginal rim. It is essential to specifically design appropriate disc prosthesis for Chinese patients. To fit the morphologic and biomechanical variations, we also propose that the disc prostheses for different vertebral segments should be separately designed.Abbreviations: 3D = three-dimensional, APD = the anteroposterior diameter, ECD = the whole endplate concavity depth, ECL = the endplate concavity apex location, SCD = the mid-sagittal plane concavity depth, SCL = the sagittal concavity apex, TD = the transverse diameter.

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“…14 Clinical and experimental trials yielded that fusion of cervical segments can remarkably expand the ROM of adjacent segments and intradiscal pressure, in this way increasing the risk of adjacent segment disorders particularly at the levels around the fusion. 15 In cadaver models, intradiscal pressures adjacent to a fused level was found to be as much as 73%. 16 The spondylotic spine is mostly linked with multiple-level degeneration.…”

Section: Discussionmentioning

confidence: 97%

“…Postoperative cervical ROM was found to be similar with the physiological state and no reduction was detected in ROM of the adjacent segment in HC cases. 15 There is no consensus on the segment for the performance of HC. Hybrid construction was indicated in patients with cervical spondylotic radiculopathy or myelopathy caused by continuous degeneration from C3 to C7, which were unresponsive to conservative treatment for at least 6 weeks.…”

Section: Discussionmentioning

confidence: 99%

Anterior Hybrid Construction of Multilevel Cervical Disc Disease and Spondylotic Spinal Stenosis: Surgical Results and Factors Affecting Adjacent Segment Problems

Yılmaz

Yücesoy

Erbayraktar

et al. 2021

Preprint

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Objective: We aimed to evaluate reliability, radiological outcomes and the impacts of anterior cervical hybrid construction on the adjacent segments for the multilevel cervical degenerative disc disease (mCDDD) and spondylotic spinal stenosis (SSS).Methods: A retrospective analysis was performed using data extracted from the medical files of 195 patients (105 males, 90 females; mean age: 47.7 years). From 2008 to 2018, these patients underwent anterior cervical hybrid construction for symptomatic contiguous at least 2-level cervical degenerative disc diseases and cervical spondylosis. Clinical and radiological data including Neck Disability Index (NDI), Visual Analogue Scale (VAS), local cervical degenerative disk disease in adjacent segments on magnetic resonance imaging (MRI) views and complications were reviewed. Results: The mean clinical and radiological follow-up was 45.2 months (range: 24 to 102). Radiculopathy and/or myelopathy were the main clinical problems in all patients. The mean VAS scores of HC for arm pain were 7.4±0.8 preoperatively; 2.8±0.6, 1 month after surgery; 2.3±0.6, 6 months after surgery; 1.8±0.6, 12 month after surgery; and 1.6±0.6, 24 months after surgery. The mean NDI scores (mean±SD) of HC significantly improved after surgery (on admission, 57.2±5.5%; 1 month after surgery, 27.35±5.3%; 6 month after surgery, 21.43±2.8%; 12 months after surgery, 21.9±2.3%; 24 months after surgery, 20.6±2.6%, p=0.006). Hoarseness and dysphagia were the most common complications and osteophyte formation was the most frequent radiographic change.Conclusion: Anterior cervical hybrid construction appears to be an acceptable option in the management of multilevel cervical degenerative disc diseases and spondylotic spinal stenosis.

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Cervical anterior hybrid technique with bi-level Bryan artificial disc replacement and adjacent segment fusion for cervical myelopathy over three consecutive segments

Cited by 19 publications

References 16 publications

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

Biomechanical comparison of noncontiguous cervical disc arthroplasty and noncontiguous cervical discectomy and fusion in the treatment of noncontinuous cervical degenerative disc disease: a finite element analysis

A morphometric study of the middle and lower cervical vertebral endplates and their components

Anterior Hybrid Construction of Multilevel Cervical Disc Disease and Spondylotic Spinal Stenosis: Surgical Results and Factors Affecting Adjacent Segment Problems

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