Clinical and radiological evaluation of cervical disc arthroplasty with 5-year follow-up: a prospective study of 384 patients

Abstract

Background Cervical total disc replacement was developed to avoid known complications of cervical fusion. The purpose of this paper was to provide 5-year follow-up results of an ongoing prospective study after implantation of cervical disc prosthesis. Methods Three hundred and eighty-four patients were treated using Mobi-C cervical disc (Zimmer Biomet, Troyes, France) and included in a prospective multicentre study. Routine clinical and radiological examinations were reported preoperatively and postoperatively with up to 5-year follow-up. Complications and revision surgeries were also explored. Results Results at 5 years showed significant improvement in all clinical outcomes (NDI, VAS for arm and neck pain, SF-36 PCS and MCS). Motion at index level increased significantly from 6.0° preoperatively to 8.0°, and 72.1% of the implanted segments were still mobile (referring to threshold of ROM > 3°). Proximal and distal adjacent discs showed no significant change in average motion 5 years after surgery compared to baseline. Ossification resulting in complete fusion was observed in 16.4% of the implanted segments. Distal and proximal adjacent disc degeneration occurred in 42.2% and 39.1% of patients, respectively. Complications rate was 8.9%, and 1.5% of the patients had reoperation at the index level. Surgery rate of adjacent discs was 2.9%. An increased percentage of working patients and a decrease in medication consumption were observed. At 5 years, 93.3% patients were satisfied regarding the overall outcome. Conclusions In this study, favourable 5-year follow-up clinical and radiological outcomes were observed with a low rate of adjacent level surgery.

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

“…As expected, variations, and similarities in the biomechanical parameters stem from individual characteristics of the CDA itself. Acknowledging that any CDA's ultimate goal is to improve the patient's quality of life and act as a superior alternative to conventional ACDF, in what follows, these responses are interpreted in light of their design differences [1,4,6,24,25].…”

<p>Spontaneous Fusion After Cervical Disc Arthroplasty: A Case Report and Literature Review</p>

“…As a relatively rare complication of CDA, SF or class IV HO after CDA has been reported a few times since it was first reported in 2005. [14][15][16][17][18][19][20][21][22][23][24][25][26] The exact incidence of SF after CDA is still unclear, and it varies greatly in the literature. 26 Oh et al reported that the incidence of SF after CDA was 3.3% (2/60).…”

Implant complications after one-level or two-level cervical disc arthroplasty

“…ACDF and CDA are the most commonly used surgical methods for the treatment of cervical degenerative diseases. [ 1 – 5 , 16 – 22 ] With the popular application of CDA, many common anterior cervical surgical complications, such as dysphagia and neck haematoma, have been reported, including prosthesis-related complications such as displacement. [ 14 , 15 ] In our study, one patient had a translucent area between the upper endplate of the prosthesis and the lower endplate of the vertebral body segment at the 3-month FU, but the patient did not complain of discomfort, and the size and position of the prosthesis were good.…”

“…Taking NSAIDs during the week and strict control of indications as well as an emphasis on intraoperative and perioperative management could reduce the incidence of HO. [ 22 , 24 ]…”