Clinical and radiological outcomes of dynamic cervical implant arthroplasty: A 5-year follow-up

Abstract

BACKGROUND Dynamic cervical implant (DCI) stabilization has been reported to have satisfactory clinical and radiological results with short- and mid-term follow-up in the treatment of cervical degenerative disc disease. However, few reports about the clinical and radiological outcome with more than 5-year follow-up exist. AIM To investigate the long-term clinical and radiological results of DCI arthroplasty. METHODS A total of 40 patients who received DCI arthroplasty were consecutively reviewed from May 2010 to August 2015. Visual analogue scale (VAS), neck disability index (NDI) score, Japanese Orthopaedic Association (JOA) score, and SF-36 items were used to assess neural function rehabilitation. Static and dynamic radiographs and 3-dimentional computed tomography were used to evaluate the radiological outcomes. RESULTS The scores of neck/arm VAS, NDI, JOA, and 8-dimensions of SF-36 were significantly improved at the 1-mo follow-up ( P < 0.05) and maintained until the last follow-up ( P < 0.05). The range of motion (ROM) of C2-C7, functional spinal unit (FSU), upper/lower adjacent level, C2-C7 lateral bending, and FSU lateral bending decreased at the 1-mo follow-up ( P < 0.05), whereas they increased to the preoperative level at the later follow-up intervals ( P > 0.05), except the ROM of FSU lateral bending ( P < 0.05). The C2-C7 alignment and FSU angle kept more lordotic at the last follow-up ( P < 0.05). The intervertebral height increased significantly at the 1-mo follow-up ( P < 0.05) and decreased at later follow-ups ( P > 0.05). At the last follow-up, 12 (26.1%) segments developed heterotopic ossification. CONCLUSION DCI arthroplasty is a safe and effective non-fusion technique to treat cervical degenerative disc disease in long-term follow-up.

Restoration of Range of Motion in the Cervical Spine through Single-Segment Artificial Disc Replacement Using the Baguera®C Prosthesis

“…The patient cohort examined in the current study demonstrated significant improvements in all clinical outcome parameters (NDI, VAS, and JOA) in comparison to baseline levels. Previous studies have also verified similar favorable clinical outcomes at different observation periods, irrespective of the type of prosthesis implanted [19][20][21][22]. It has been suggested that higher pre-operative NDI scores are associated with a more pronounced C2-C7 sagittal vertical axis and reduced cervical lordosis [23].…”

CORR Insights®: A Dynamic Interbody Cage Improves Bone Formation in Anterior Cervical Surgery: A Porcine Biomechanical Study

“…Existing clinical studies on dynamic cervical implants are retrospective, lack comparison groups, and are based on small sample sizes. An earlier pilot study involving 53 patients who underwent dynamic cervical implant treatment [8] showed improvement in Neck Disability Index score, VAS pain scores, and neurological deficits at a minimum of 24 months, and more recently, another study [14] involving 40 patients reported similar improvement in outcomes at a 5-year follow-up. These encouraging early data were promising in the broad concept of “dynamic fusion,” but a natural follow-up question is “which specific design is preferable?,” or in other words, does specific dynamic interbody fusion cage design matter?…”