Cervical arthroplasty with Discover prosthesis: clinical outcomes and analysis of factors that may influence postoperative range of motion

Li, Jun; Liang, Lijun; Ye, Xiaofei; Qi, Min; Chen, Huajiang; Yuan, Wen

doi:10.1007/s00586-013-2897-z

Cited by 22 publications

(13 citation statements)

References 26 publications

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“…The results of this study demonstrated promising clinical and radiological outcomes. Concerning the NDI the observation showed a significant improvement of 51.5 % ( p < 0.001) after implantation which correlates with present studies of other available cervical disc prosthesis [ 4 – 6 ]. Analysis of VAS showed a significant reduction of neck and arm pain early after surgery which might primarily be related to sufficient decompression during surgery and the in-hospital pain management.…”

Section: Discussionsupporting

confidence: 91%

“…According to prior clinical trials of cervical arthroplasty subsequent secondary surgical intervention was defined as any revision, removal, reoperation or supplemental fixation [ 1 , 4 – 6 ]. Until the last follow-up in one case (2.2 %) an increase of neck and arm pain was observed and subsequent secondary surgical intervention was required to remove a probably undersized prosthesis.…”

Section: Discussionmentioning

confidence: 99%

“…As published by Sasso et al [ 1 ], Burkus et al [ 7 ] and Anderson and Hashimoto [ 19 ] for other disc prostheses the results of this study show a very low rate of secondary procedures and no prostheses related complications during or after surgery. According to Li et al [ 6 ] proper selection of patients, exact intraoperative strategy and adequate neural decompression is required to achieve satisfactory clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

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

Obernauer

Landscheidt

Hartmann

et al. 2016

BMC Musculoskelet Disord

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BackgroundCervical Disc Arthroplasty (CDA) seems to be an alternative to Anterior Cervical Decompression and Fusion (ACDF) and was developed to minimize the risk of Adjacent Segment Disease (ASD). The ROTAIO Cervical Disc Prosthesis represents a new unconstrained implant with a variable centre of rotation which should enable physiological facet-guided movement. The aim of this current study was to evaluate the clinical outcomes after arthroplasty using ROTAIO Cervical Disc Prosthesis.MethodTwenty-seven female and 18 male patients (n = 45) with a mean age of 43.7 ± 7.8 years were prospectively followed up for a maximum of 24 month. Clinical outcomes were assessed by Neck Disability Index (NDI), visual analogue scale (VAS) scores for neck and arm pain, patients´ overall satisfaction and the usage of analgesics. Additionally, radiographic information including ROM of the functional spinal unit (FSU) and signs of adjacent segment disease were recorded.ResultsNDI and VAS scores showed significant improvement 6 months after surgery and at last follow-up (p < 0.001). Concerning overall satisfaction 95.7 % of the patients showed good to excellent results at the last visit and a significant reduction of analgesic usage was observed (p < 0.001). Radiographic measurements showed a mean increase of ROM up to 8.40° in the treated FSU at last follow-up (p < 0.001). No signs of anterior migration or dislocation of the prosthesis and no subsidence was recorded radiographically. There were no major complications and a low rate of secondary procedures (2.2 %).ConclusionIn the 24-months follow-up the ROTAIO Cervical Disc Prosthesis provided excellent clinical and radiographical results and seems to be safe and effective for the treatment of symptomatic single-level degenerative disc disease.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Obernauer

Landscheidt

Hartmann

et al. 2016

BMC Musculoskelet Disord

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“…35 None of the patients in this study had any neurological impairment, and the decision to undergo revision surgery was due to the results of this motion analysis, showing highly instable implants, in combination with increased neck pain. A previously published motion study of the same artificial disc reported migration in 6 of 55 patients (11%), 10 although evaluations were done with plain radiographs. Other previous radiographic studies on other artificial discs have not reported similar figures concerning loosening or migration to the same extent.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of mobility and stability in the Discover artificial disc: an in vivo motion study using high-accuracy 3D CT data

Skeppholm

Svedmark

Noz

et al. 2015

SPI

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OBJECT Artificial disc replacement (ADR) devices are unlike implants used in cervical fusion in that they are continuously exposed to stress not only within the implant site but also at their site of attachment to the adjacent vertebra. An imaging technique with higher accuracy than plain radiography and with the possibility of 3D visualization would provide more detailed information about the motion quality and stability of the implant in relation to the vertebrae. Such high-accuracy studies have previously been conducted with radiostereometric analysis (RSA), which requires implantation of tantalum markers in the adjacent vertebrae. The aim of this study was to evaluate in vivo motion and stability of implanted artificial discs. A noninvasive analysis was performed with CT, with an accuracy higher than that of plain radiographs and almost as high as RSA in cervical spine. METHODS Twenty-eight patients with ADR were included from a larger cohort of a randomized controlled trial comparing treatment of cervical radiculopathy with ADR or anterior cervical decompression and fusion. Surgical levels included C4–7; 18 patients had 1-level surgery and 10 patients had 2-level surgery. Follow-up time ranged from 19 to 50 months, with an average of 40 months. Two CT volumes of the cervical spine, 1 in flexion and 1 in extension, were obtained in each patient and then spatially registered using a customized imaging tool, previously used and validated for the cervical spine. Motion between the components in the artificial disc, as well as motion between the components and adjacent vertebrae, were calculated in 3 planes. Intraclass correlation (ICC) between independent observers and repeatability of the method were also calculated. RESULTS Intrinsic motion, expressed as degrees in rotation and millimeters in translation, was detectable in a majority of the ADRs. In the sagittal plane, in which the flexion/extension was performed, sagittal rotation ranged between 0.2° and 15.8° and translation between 0.0 and 5.5 mm. Eight percent of the ADRs were classified as unstable, as motion between at least 1 of the components and the adjacent vertebra was detected. Five percent were classified as ankylotic, with no detectable motion, and another 8% showed very limited motion due to heterotopic ossification. Repeatability for the motion in the sagittal plane was calculated to be 1.30° for rotation and 1.29 mm for translation (95% confidence level), ICC 0.99 and 0.84, respectively. All 3 patients with unstable devices had undergone 1-level ADRs at C5–6. They all underwent revision surgery due to increased neck pain, and instability was established during the surgery. CONCLUSIONS The majority of the artificial discs in this study showed intrinsic mobility several years after implantation and were also shown to be properly attached. Implant instability was detected in 8% of patients and, as all of these patients underwent revision surgery due to increasing neck pain, this might be a more serious problem than heterotopic bone formation.

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“…В настоящее время тотальная артропластика МПД, как современный альтернативный способ хирургического лечения дегенеративного заболевания МПД, набирает все большую популярность во многих нейрохирургических клиниках мира [5,6]. Целью артропластики МПД являются полное восстановление и поддержание физиологического объема движений в позвоночно-двигательном сегменте, что позволяет предотвратить дегенерацию смежных МПД, нивелировать болевой синдром и неврологическую симптоматику [7].…”

Section: Analysis Of the Results Of Total Cervical Disc Arthroplasty unclassified

Analysis of the results of total cervical disc arthroplasty using a M6-C prosthesis: a multicenter study

et al. 2017

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The study included 112 patients (77 males and 35 females). All patients underwent single-level discectomy with implantation of the artificial IVD prosthesis M6-C. The follow-up period was up to 36 months. Dynamic assessment of the prosthesis was based on clinical parameters (pain intensity in the cervical spine and upper extremities (visual analog scale - VAS); quality of life (Neck Disability Index - NDI)); and subjective satisfaction with the results of surgical treatment (Macnab scale) and instrumental data (range of motion in the operated spinal motion segment, degree of heterotopic ossification (McAfee-Suchomel classification), and time course of degenerative changes in the adjacent segments).

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Cervical arthroplasty with Discover prosthesis: clinical outcomes and analysis of factors that may influence postoperative range of motion

Cited by 22 publications

References 26 publications

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

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

Evaluation of mobility and stability in the Discover artificial disc: an in vivo motion study using high-accuracy 3D CT data

Analysis of the results of total cervical disc arthroplasty using a M6-C prosthesis: a multicenter study

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