Cervical artificial disc replacement with ProDisc-C: Clinical and radiographic outcomes with long-term follow-up

Malham, Gregory M.; Parker, Rhiannon M.; Ellis, N.; Chan, Philip; Varma, Dinesh

doi:10.1016/j.jocn.2013.09.013

Cited by 35 publications

(24 citation statements)

References 17 publications

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“…However, CDA remains one of the most widely accepted candidates for selection in order to treat cervical spondylosis. In addition, with the passage of time, several published studies have revealed that there are certain untoward reactions associated with this procedure, including heterotopic ossification, which may limit the ROM of the operation segment following the surgery (7,8). …”

Section: Discussionmentioning

confidence: 99%

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Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis

2016

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Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are the most commonly used procedures in cervical spondylosis. However, only a few published studies exist in the literature comparing these two operation types, particularly its mid-term efficacy and safety. Furthermore, in those studies, even large sample trials, when compared, have elicited controversial results, making it inconvenient for clinicians to refer to them. The aim of the present study was to clarify the advantages and shortcomings of the two procedures. Articles indexed in the PubMed, Web of Science, Cochrane Library, EMBASE, China Biological Medicine and China National Knowledge Infrastructure (CNKI) databases, as of March 2016, that met our criteria were searched. A total of 18 trials involving 3,040 patients were included in our final analysis. The most important results drawn from the present analysis were as follows: Insignificant differences were identified in the blood loss [weighted mean difference (WMD)=6.23; 95% confidence intervals (CI), −0.85 to 13.32; P=0.08], surgical time [standardized mean difference (SMD)=0.40; 95% CI, −0.01 to 0.82; P=0.06], the time of hospital stay (SMD=0.05; 95% CI, −0.28 to 0.37; P=0.77) and the total complications rate [odds ratio (OR)=0.86; 95% CI, 0.66 to 1.131; P=0.28] on a comparison of the two operation methods. By contrast, comparing CDA with ACDF, the CDA had higher Short Form survey (SF-36) scores (WMD=1.65; 95% CI, 0.61 to 2.69; P=0.002), a larger range of motion in the operation level (SMD=6.53; 95% CI, 3.89 to 9.17; P<0.0001), a higher rate of neurological improvement following the operation (OR=1.80; 95% CI, 1.29 to 2.52; P=0.0006), a lower Visual Analog Scale (VAS) score of neck pain (WMD= 0.16; 95% CI, −0.28 to 0.05; P=0.006) and arm pain (WMD= 0.12; 95% CI, −0.24 to −0.01; P=0.04). In addition, in the mid-term following the surgery, CDA had a lower Neck Disability Index (NDI; SMD=0.18; 95% CI, −0.28 to −0.07; P=0.001) and a lower reoperation rate of adjacent levels (OR=0.54; 95% CI, 0.35 to 0.85; P=0.007) compared with ACDF. Taken together, these results suggested that CDA and ACDF are efficient and safe methods for dealing with cervical spondylosis. However, with respect to certain specific indicators, such as the reoperation rate of adjacent levels following surgery, the former has several advantages.

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Section: Discussionmentioning

confidence: 99%

“…However, over time, several studies have indicated certain untoward adverse effects resulting from this procedure, including increased neck and/or arm pain following the operation and heterotopic ossification (7,8). …”

Section: Introductionmentioning

confidence: 99%

Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis

2016

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“…[16][17][18][19] Numerous studies have demonstrated that C-ADR maintains motion at the operated level and decreases strain on the adjacent segment, which helps to prevent ASD. [33][34][35] Sasso et al 35 also concluded that C-ADR is superior to ACDF in a 4-year follow-up study with level I evidence. 32 Indeed, recent long-term follow-up studies have found that C-ADR is a safe option for patients that provides excellent clinical outcomes, satisfactory return to work rates, and maintenance of segmental motion on long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

Oh²,

Shin³

et al. 2017

Clinical Spine Surgery: A Spine Publication

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“…[414] One of the proposed advantageous of CAD is that it allows patients to return to work sooner than ACDF. [89] There are also military-based studies showing that patients undergoing CAD can return to unrestricted full-active duty 10 weeks after the surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[514] Long-term outcomes suggest that TDR has a low risk of adverse events such as device failure or migration, return of symptoms, ASD, and need for revision surgery. [414] While these results are encouraging, TDR is still a relatively new technique that has been less studied than ACDF. In this report, a case of symptomatic anterior artificial disc extrusion 14 months after cervical TDR with ProDisc-C (DePuy Synthes, West Chester, PA, USA) is presented.…”

Section: Introductionmentioning

confidence: 99%

Cervical artificial disc extrusion after a paragliding accident

Niu¹,

Hoffman²,

Lu³

2017

Surg Neurol Int

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Background:Cervical total disc replacement (TDR) is an established alternative to anterior cervical discectomy and fusion (ACDF) with excellent long-term outcomes and low failure rates. Cases of implant failure and migration are scarce and primarily limited to several years postoperatively. The authors report a case of anterior extrusion of a C4-C5 ProDisc-C (DePuy Synthes, West Chester, PA, USA) cervical artificial disc (CAD) 14 months after placement due to minor trauma.Case Description:A 33-year-old female who had undergone C4-C5 CAD implantation presented with neck pain and spasm after experiencing a paragliding accident. A 4 mm anterior protrusion of the CAD was seen on x-ray. She underwent removal of the CAD followed by anterior fusion. Other cases of CAD extrusion in the literature are discussed and the device's durability and testing are considered.Conclusion:Overall, CAD extrusion is a rare event. This case is likely the result of insufficient osseous integration. Patients undergoing cervical TDR should avoid high-risk activities to prevent trauma that could compromise the disc's placement, and future design/research should focus on how to enhance osseous integration at the interface while minimizing excessive heterotopic ossification.

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Cervical artificial disc replacement with ProDisc-C: Clinical and radiographic outcomes with long-term follow-up

Cited by 35 publications

References 17 publications

Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis

Mid-term efficacy and safety of cervical disc arthroplasty versus fusion in cervical spondylosis: A systematic review and meta-analysis

Artificial Disk Replacement Combined With Fusion Versus 2-Level Fusion in Cervical 2-Level Disk Disease With a 5-Year Follow-up

Cervical artificial disc extrusion after a paragliding accident

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