Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis

Du, Junjie; Li, Mo; Líu, Hao; Meng, Hui; He, Qizhen; Luo, Zhuojing

doi:10.1016/j.spinee.2011.01.037

Cited by 40 publications

(26 citation statements)

References 23 publications

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“…The implant is available in five sizes and five heights (5-9 mm).The DISCOVER disc has been CE marked (04-2006) and has received premarket approval for an IDE study in the USA. Related clinical outcomes have been previously reported [2,8,11]. The mean disc height was 6.7 ± 0.7 mm (range, 6-8 mm).…”

Section: Patient Samplementioning

confidence: 63%

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

et al. 2012

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Introduction To better understand cervical kinematics following cervical disc replacement (CDR), the in vivo behavior of a minimally constrained CDR was assessed. Methods Radiographic analysis of 19 patients undergoing a 1-level CDR from C4-5 to C6-7 (DISCOVER, DepuySpine, USA) was performed. Neutral-lateral and flexionextension radiographs obtained at preop, postop and late follow-up were analyzed for segmental angle and global angle (GA C2-7). Flexion-extension range of motion was analyzed using validated quantitative motion analysis software (QMAÒ, Medical Metrics, USA). The FSU motion parameters measured at the index and adjacent levels were angular range of motion (ROM), translation and center of rotation (COR). Translation and COR were normalized to the AP dimension of the inferior endplate of the caudal vertebra. All motion parameters, including COR, were compared with normative reference data. Results The average patient age was 43.5 ± 7.3 years. The mean follow-up was 15.3 ± 7.2 months. C2-7 ROM was 35.9°± 15.7°at preop and 45.4°± 13.6°at follow-up (Dp\ .01). Based on the QMA at follow-up, angular ROM at the CDR level measured 9.8°± 5.9°and translation was 10.1 ± 7.8 %. Individuals with higher ROM at the CDR level had increased translation at that level (p \ .001, r = 0.97), increased translation and ROM at the supra-adjacent level (p \ .001, r = .8; p = .005, r = .6). There was a strong interrelation between angular ROM and translation at the supra-adjacent level (p \ .001, r = .9) and caudal-adjacent level (p\.001, r = .9). The location of the COR at the CDRand supra-adjacent levels was significantly different for the COR-X (p \ .001). Notably, the COR-Y at the CDR level was significantly correlated with the extent of CDR-level translation (p = .02, r = .6). Shell angle, which may be influenced by implant size and positioning had no impact on angular ROM but was correlated with COR-X (p = .05, r = -.6) and COR-Y (p = .04, r = -.5). Conclusion The COR is an important parameter for assessing the ability of non-constrained CDRs to replicate the normal kinematics of a FSU. CDR size and location, both of which can impact shell angle, may influence the amount of translation by affecting the location of the COR. Future research is needed to show how much translation is beneficial concerning clinical outcomes and facet loading.

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Section: Patient Samplementioning

confidence: 63%

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

et al. 2012

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“…The effectiveness of CDR in treating cervical degenerative disc diseases has been confirmed in many studies [4,6,8,18,19]. CDR can maintain the motion of the treated segment and contribute to physiological alignment of the treated segment and overall cervical spine.…”

Section: Discussionmentioning

confidence: 99%

“…Until now, few reports on the clinical application of Discover disc have been published. Du et al [4] first reported the early follow-up outcomes of the Discover disc CDR, and demonstrated that it increased the FSU motion and maintained the FSU angle postoperatively. Patients achieved good clinical outcome and no complications occurred during or after the surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…Most authors [1-10, 12, 19] observed the effect of general motion preservation at the implanted level regardless of the specific prosthesis design. In those studies, some groups have shown an increased motion [1][2][3][4], whereas others have shown no change [5][6][7] or decreased motion [8][9][10]. In contrast to Du et al [4], CDR with the Discover disc was able to maintain a mean of 8.4 ± 6.3°of FSU ROM at the 2-year follow-up in our group, which was significantly less than the preoperative ROM (P = 0.008).…”

Section: Discussionmentioning

confidence: 99%

“…Some prostheses have shown increased ROM postoperatively [1][2][3][4], while others have shown no change [5][6][7] or decreased ROM [8][9][10]. Interestingly, some prostheses have been shown to aid in restoration of cervical lordosis postoperatively [11][12][13][14], while others have shown no change [2,4] or trend toward kyphosis [5,15,16]. As a newly developed device, few reports about the Discover artificial cervical disc (DePuy Spine, Raynham, MA, USA) arthroplasty have been published.…”

Section: Introductionmentioning

confidence: 99%

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

Liang

et al. 2013

Eur Spine J

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Purpose The aim of this current study was to analyze the clinical outcomes after Discover cervical disc replacement and its effects on maintaining cervical lordosis and range of motion (ROM). The possible factors influencing postoperative ROM were analyzed. Method 27 men and 28 women with a mean age of 46.4 ± 8.7 years were prospectively followed up for 2 years. Clinical outcomes were assessed using Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), visual analog scale (VAS) and Odom's criteria. Radiographic information including segment and overall alignment, functional spinal unit (FSU) and overall ROM, and disc heights were prospectively collected during the follow-up. The correlations between the postoperative FSU ROM at last follow-up and influencing factors were analyzed. Results Mean NDI, JOA and VAS scores showed statistical improvements at last follow-up. Anterior migration of the prosthesis was detected in six cases. Heterotopic ossification was observed in ten patients. Mean FSU angle, endplate angle of the treated level and mean overall cervical alignment were all improved significantly at last follow-up (P \ 0.001). However, mean FSU ROM of the treated segment significantly decreased postoperatively (P = 0.008), while mean overall ROM showed no significant differences. A significant correlation was found between preoperative FSU ROM and postoperative FSU ROM by the Pearson correlation coefficient (r = 0.325, P = 0.034). Multiple linear regression analysis confirmed that preoperative FSU ROM contributed independently to a model with a coefficient of determination of 0.37 (P = 0.034). Conclusions In the 2 years follow-up, the Discover cervical disc arthroplasty has provided satisfactory clinical outcomes. It was able to substantially restore segment and overall cervical alignment while partially maintaining segment and overall cervical ROM. Additionally, we found that postoperative FSU ROM positively correlated with preoperative FSU ROM.

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Will There be a Role for Disc Prostheses in Small Animals?

Adamo¹,

Forterre²

2014

Advances in Intervertebral Disc Disease in Dogs and Cats

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Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis

Cited by 40 publications

References 23 publications

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

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

Will There be a Role for Disc Prostheses in Small Animals?

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