Clinical and radiographic outcomes of cervical disc arthroplasty with Prestige-LP Disc: a minimum 6-year follow-up study

Zeng, Junfeng; Líu, Hao; Xiao, Rong; Wang, Beiyu; Yang, Yi; Gao, Xinlin; Wu, Tingkui; Hong, Ying

doi:10.1186/s12891-018-2201-9

Cited by 12 publications

(5 citation statements)

References 26 publications

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“…Cervical disc arthroplasty was developed to mitigate problems attributed to fusion, that is, maintaining a greater range of motion and preventing adjacent segment degeneration [1][2][3][4][5][6][7][8][9][10]. However, cervical disc replacements (CDRs) have introduced new complications to the spine, previously observed at the larger, synovial joints [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

et al. 2022

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Background Periprosthetic bone loss is a common observation following arthroplasty. Recognizing and understanding the nature of bone loss is vital as it determines the subsequent performance of the device and the overall outcome. Despite its significance, the term “bone loss” is often misused to describe inflammatory osteolysis, a complication with vastly different clinical outcomes and treatment plans. Therefore, the goal of this review was to report major findings related to vertebral radiographic bone changes around cervical disc replacements, mitigate discrepancies in clinical reports by introducing uniform terminology to the field, and establish a precedence that can be used to identify the important nuances between these distinct complications. Methods A systematic review of the literature was conducted following PRISMA guidelines, using the keywords “cervical,” “disc replacement,” “osteolysis,” “bone loss,” “radiograph,” and “complications.” A total of 23 articles met the inclusion criteria with the majority being retrospective or case reports. Results Fourteen studies reported periprosthetic osteolysis in a total of 46 patients with onset ranging from 15–96 months after the index procedure. Reported causes included: metal hypersensitivity, infection, mechanical failure, and wear debris. Osteolysis was generally progressive and led to reoperation. Nine articles reported non-inflammatory bone loss in 527 patients (52.5%), typically within 3–6 months following implantation. The reported causes included: micromotion, stress shielding, and interrupted blood supply. With one exception, bone loss was reported to be non-progressive and had no effect on clinical outcome measures. Conclusions Non-progressive, early onset bone loss is a common finding after CDA and typically does not affect the reported short-term pain scores or lead to early revision. By contrast, osteolysis was less common, presenting more than a year post-operative and often accompanied by additional complications, leading to revision surgery. A greater understanding of the clinical significance is limited by the lack of long-term studies, inconsistent terminology, and infrequent use of histology and explant analyses. Uniform reporting and adoption of consistent terminology can mitigate some of these limitations. Executing these actionable items is critical to assess device performance and the risk of revision. Level of Evidence IV Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

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Section: Introductionmentioning

confidence: 99%

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

et al. 2022

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“…Regardless, most studies seem to agree that the prevalence of HO increases over time. [16][17][18][19][20] Another study conducted by our institution found that except for loss of ROM, which was caused only by high-grade HO, the appearance of HO did not worsen the clinical outcomes of these patients. 27 Existing studies from other institutions also showed that there were no significant differences in terms of clinical outcomes, including scores for the Neck Disability Index and the SF-36 physical and mental components, between the HO and non-HO groups.…”

Section: Discussionmentioning

confidence: 91%

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data

Zhou

Zhao

et al. 2020

Journal of Neurosurgery: Spine

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OBJECTIVEThe authors aimed to identify factors that may be useful for quantifying the amount of degenerative change in preoperative patients to identify ideal candidates for cervical disc replacement (CDR) in patients with a minimum of 10 years of follow-up data.METHODSDuring the period from December 2003 to August 2008, 54 patients underwent CDR with a Bryan cervical disc prosthesis performed by the same group of surgeons, and all of the patients in this group with at least 10 years of follow-up data were enrolled in this retrospective analysis of cases. Postoperative bone formation was graded in radiographic images by using the McAfee classification for heterotopic ossification. Preoperative degeneration was evaluated in radiographs based on a quantitative scoring system. After univariate analysis, the authors performed multifactor logistic regression analysis to identify significant factors. To determine the cutoff points for the significant factors, a receiver operating characteristic (ROC) curve analysis was conducted.RESULTSStudy patients had a mean age of 43.6 years and an average follow-up period of 120.3 months. The patients as a group had a 68.2% overall incidence of bone formation. Based on univariate analysis results, data for patient sex, disc height, and the presence of anterior osteophytes and endplate sclerosis were included in the multivariate analysis. According to the analysis results, the identified independent risk factors for postoperative bone formation included disc height, the presence of anterior osteophytes, and endplate sclerosis, and according to a quantitative scoring system for degeneration of the cervical spine based on these variables, the ROC curve indicated that the optimal cutoff scores for these risk factors were 0.5, 1.5, and 1.5, respectively.CONCLUSIONSAmong the patients who were followed up for at least 10 years after CDR, the incidence of postoperative bone formation was relatively high. The study results indicate that the degree of degeneration in the target level before surgery has a positive correlation with the incidence of postoperative ossification. Rigorous indication criteria for postoperative ossification should be applied in patients for whom CDR may be a treatment option.

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“…Ideally, an injectable, in situ curable hydrogel would aid in the restoration of disc structure and function by establishing a protective microenvironment conducive to cell proliferation, extracellular matrix deposition, and the gradual release of bioactive chemicals within the diseased disc's non-vascular milieu. The existing mechanical IVD prostheses [23][24][25] can only be used to replace the nucleus pulposus and are unable to promote the regeneration and repair of nucleus pulposus tissue. Additionally, they restrict their application due to the risk of complications from prosthesis displacement and the implantation process [25].…”

Section: Hydrogels: An Overviewmentioning

confidence: 99%

“…The existing mechanical IVD prostheses [23][24][25] can only be used to replace the nucleus pulposus and are unable to promote the regeneration and repair of nucleus pulposus tissue. Additionally, they restrict their application due to the risk of complications from prosthesis displacement and the implantation process [25]. As a result, the research focus has shifted to the creation of biologically active hydrogels with simple compositions and synthesis for tissue regeneration.…”

Section: Hydrogels: An Overviewmentioning

confidence: 99%

Hydrogel-Based Strategies for Intervertebral Disc Regeneration: Advances, Challenges and Clinical Prospects

Desai,

Srinivasan,

Kumbar

et al. 2024

Gels

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Millions of people worldwide suffer from low back pain and disability associated with intervertebral disc (IVD) degeneration. IVD degeneration is highly correlated with aging, as the nucleus pulposus (NP) dehydrates and the annulus fibrosus (AF) fissures form, which often results in intervertebral disc herniation or disc space collapse and related clinical symptoms. Currently available options for treating intervertebral disc degeneration are symptoms control with therapy modalities, and/or medication, and/or surgical resection of the IVD with or without spinal fusion. As such, there is an urgent clinical demand for more effective disease-modifying treatments for this ubiquitous disorder, rather than the current paradigms focused only on symptom control. Hydrogels are unique biomaterials that have a variety of distinctive qualities, including (but not limited to) biocompatibility, highly adjustable mechanical characteristics, and most importantly, the capacity to absorb and retain water in a manner like that of native human nucleus pulposus tissue. In recent years, various hydrogels have been investigated in vitro and in vivo for the repair of intervertebral discs, some of which are ready for clinical testing. In this review, we summarize the latest findings and developments in the application of hydrogel technology for the repair and regeneration of intervertebral discs.

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Clinical and radiographic outcomes of cervical disc arthroplasty with Prestige-LP Disc: a minimum 6-year follow-up study

Cited by 12 publications

References 26 publications

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

Quantitative analysis of the correlation between preoperative cervical degeneration and postoperative heterotopic ossification after cervical disc replacement: minimum 10-year follow-up data

Hydrogel-Based Strategies for Intervertebral Disc Regeneration: Advances, Challenges and Clinical Prospects

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