Footprint Mismatch of Cervical Disc Prostheses with Chinese Cervical Anatomic Dimensions

Li, Dong; Tan, Mingsheng; Yan, Qin-Hua; Yi, Ping; Yang, Feng; Tang, Xiuwen; Hao, Qingying

doi:10.4103/0366-6999.149200

Cited by 23 publications

(13 citation statements)

References 25 publications

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“…One study found a large discrepancy between footprints of prostheses and Chinese cervical anatomic data in 414 segments. 18 In the present study, measurements of 400 segments produced similar results.…”

Section: Discussionsupporting

confidence: 82%

Discrepancy between cervical disc prostheses and anatomical cervical dimensions

Karaca

Akpolat

Öztermeli

et al. 2016

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to assess appropriateness of the sizes of available cervical disc prostheses based on tomographic measurement of human cervical vertebrae.MethodsThe anatomic dimensions of the C3–C7 segments were measured on 50 patients (age range 26–47 years) with computerized tomography scan and compared with the sizes of the popular cervical total disc prostheses (CTDP) at the market [Bryan (Medtronic), Prodisc-C (Synthes), Prestige LP (Medtronic), Discover (DePuy)]. The mediolateral and anteriorposterior diameters of the upper and lower endplates were measured with a digital measuring system.ResultsOverall, 43.7% of the largest implant footprints were smaller in the anterior-posterior diameter and 42.6% in the mediolateral diameter were smaller than cervical endplate measurements. Discrepancy of the level C5/C6 and C6/C7 was calculated as 56.2% at the anteroposterior diameter and 43.8% at the center of mediolateral diameter.ConclusionLarge disparity has been found between the sizes of devices and cervical anatomic data.Companies that produce CTDP should take care of the anatomical dimensions and generate different sizes of CTDP. Spine surgeon should be familiar with the size mismatch in CTDP that may affect the clinical and radiological outcome of the surgery.

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Section: Discussionsupporting

confidence: 82%

Discrepancy between cervical disc prostheses and anatomical cervical dimensions

Karaca

Akpolat

Öztermeli

et al. 2016

Acta Orthopaedica et Traumatologica Turcica

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“…[ 11 , 12 ] In fact, there is a large mismatch of available parameters of disc prostheses, as well as Chinese cervical anatomic data: 17.03% to 57.61% in the anterior–posterior diameter and 35.51% to 94.93% in the center of mediolateral diameter. [ 13 ]…”

Section: Introductionmentioning

confidence: 99%

A morphometric study of the middle and lower cervical vertebral endplates and their components

Feng

Fang²,

Huang³

et al. 2017

Medicine

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Cervical disc arthroplasty is a common method of treating cervical degenerative disease. However, the footprints of most prosthesis dimensions are obtained from data of Caucasian individuals. Besides, there is a large discrepancy between footprints of currently available cervical disc prostheses and anatomic dimensions of cervical endplates. We aimed to detail the three-dimensional (3D) anatomic morphology of the subaxial cervical vertebral endplate, utilizing high-precision, high-resolution scanning equipment, and provide a theoretical basis for designing appropriate disc prostheses for Chinese patients.A total of 138 cervical vertebral endplates were studied. Each endplate was digitized using a non-contact optical 3D range scanning system and then reconstructed to quantify diameters and surface area for the whole endplate and its components (central endplate and epiphyseal rim). The whole endplate and mid-plane concavity depth were measured.There is marked morphologic asymmetry, in that the cranial endplate is more concave than the corresponding caudal endplate, with endplate concavity depths of 2.04 and 0.69 mm, respectively. For the caudal endplates, the endplate concavity apex locations were always located in the posterior portion (81.42%), while in cranial endplates relatively even. The central endplate was approximately 60% of the area of the whole endplate and the anterior section of the ring was the widest. From C3/4 down to C6/7 discs, the vertebral endplate gradually became more elliptical. Chinese cervical endplate anatomic sizes are generally smaller than that of Caucasians. Although Korean and Chinese individuals both belong to the Asian population subgroup, the majority of anatomic dimensions differ. Singaporean cervical endplate morphology is very similar to that of Chinese patients.We performed a comprehensive and accurate quantitative description of the cervical endplate, which provide references to shape and profile an artificial cervical disc without sacrificing valuable bone stock. To design a device with footprint as large as possible to distribute the axial load, we suggest that additional attention should be paid to the marginal rim. It is essential to specifically design appropriate disc prosthesis for Chinese patients. To fit the morphologic and biomechanical variations, we also propose that the disc prostheses for different vertebral segments should be separately designed.Abbreviations: 3D = three-dimensional, APD = the anteroposterior diameter, ECD = the whole endplate concavity depth, ECL = the endplate concavity apex location, SCD = the mid-sagittal plane concavity depth, SCL = the sagittal concavity apex, TD = the transverse diameter.

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“…The arcuate surface of the novel prosthesis can provide a greater effective contact area between the prosthesis and cervical endplate, in order to disperse the axial load more evenly. Second, the novel prosthesis is designed according to the anatomy of cervical vertebra and the people’s physical size of the cervical disc in China [ 14 , 15 ], providing a better size match between the prosthesis and cervical vertebra. Size match between the prosthesis and cervical vertebra can not only provide a greater contact area between the prosthesis and cervical endplate but also can cover the peripheral marginal zones of cervical endplate which provide a much stronger support than the central areas [ 11 – 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Besides, size mismatch in the current available cervical disc prostheses is another noteworthy issue, since an undersized prosthesis is unable to cover the peripheral marginal zones of the endplate whose biomechanical strength is much larger than that of the central areas so as to increase the probability of prosthesis subsidence [ 11 – 13 ]. Therefore, according to the anatomy of cervical vertebra and the people’s physical size of cervical disc in China [ 14 , 15 ], we designed a novel artificial disc prosthesis (Pretic-I, Trauson) based on the physiological curvature of cervical endplate, with an advantage of increasing the contact area between the prosthesis and endplate to disperse the axial load.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical evaluation of cervical disc replacement with a novel prosthesis based on the physiological curvature of endplate

Lou

Wang

et al. 2018

J Orthop Surg Res

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BackgroundMost of the current available cervical disc prostheses present a flat surface instead of an arcuate surface which is most similar to the morphology of cervical endplate. Therefore, we designed a novel prosthesis (Pretic-I, Trauson) based on the physiological curvature of the cervical endplate. Biomechanical evaluation of cervical disc replacement (CDR) with this novel prosthesis was performed and compared with the Prestige LP prosthesis.MethodsThree motion segments of 18 cadaveric cervical specimens (C2-C7) were evaluated with a 75 N follower load. Overall, the biomechanics of three models, intact specimen, CDR with the novel prosthesis and CDR with the Prestige LP prosthesis, were studied to gain insight into the effective function of the novel prosthesis. The range of motion (ROM) of all three segments and intradiscal pressure (IDP) on adjacent levels were measured and analysed.ResultsCompared to the intact condition, the ROM of all three segments showed no significant difference in the replacement group. Moreover, there was also no significant difference in the ROM between the two prostheses. Besides, the IDP on the cranial adjacent level showed no obvious difference between the two prostheses; nevertheless, the IDP on the caudal adjacent level of the novel prosthesis was significantly less than the Prestige LP prosthesis.ConclusionsIn summary, the novel disc prosthesis was effective to maintain the ROM at the target segment and adjacent segments. Besides, CDR with the novel prosthesis could reduce the IDP on the caudal adjacent level to a certain extent, compared with the Prestige LP prosthesis.Electronic supplementary materialThe online version of this article (10.1186/s13018-018-0748-7) contains supplementary material, which is available to authorized users.

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Footprint Mismatch of Cervical Disc Prostheses with Chinese Cervical Anatomic Dimensions

Cited by 23 publications

References 25 publications

Discrepancy between cervical disc prostheses and anatomical cervical dimensions

Discrepancy between cervical disc prostheses and anatomical cervical dimensions

A morphometric study of the middle and lower cervical vertebral endplates and their components

Biomechanical evaluation of cervical disc replacement with a novel prosthesis based on the physiological curvature of endplate

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