Metal-on-metal versus metal-on-plastic artificial discs in two-level anterior cervical disc replacement: a meta-analysis with follow-up of 5 years or more

Coban, Daniel; Pompliano, Michael; Changoor, Stuart; Dunn, Conor; Sinha, Kumar; Hwang, Ki Soo; Faloon, Michael; Emami, Arash

doi:10.1016/j.spinee.2021.04.018

Cited by 8 publications

(8 citation statements)

References 28 publications

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“…Coban et al performed a meta-analysis and systemic review of previously published reports that evaluated patient-reported clinical outcomes, overall reoperation rates, complications, and rates of adjacent disc disease between CADs with metal-on-plastic and metal-on-metal designs. 58 ) They found superior clinical outcomes for metal-on-metal CAD in 2-level ACDR but higher rates of adjacent disc disease that require secondary surgery compared with metal-on-plastic CAD during a follow-up period of 5 years or longer. The path of motion of the instant center of rotation (COR) in the cervical spine during in vivo dynamic flexion-extension is the key issue in the design of CAD.…”

Section: Discussionmentioning

confidence: 96%

Safety and Validity of Anterior Cervical Disc Replacement for Single-level Cervical Disc Disease: Initial Two-year Follow-up of the Prospective Observational Post-marketing Surveillance Study for Japanese Patients

Takami

Hara

et al. 2022

Neurol. Med. Chir.(Tokyo)

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Anterior cervical disc replacement (ACDR) using cervical artificial disc (CAD) has the advantage of maintaining the range of motion (ROM) at the surgical level, subsequently reducing the postoperative risk of adjacent disc disease. Following the approval for the clinical use in Japan, a post-marketing surveillance (PMS) study was conducted for two different types of CAD, namely, Mobi-C (metal-onplastic design) and Prestige LP (metal-on-metal design). The objective of this prospective observational multicenter study was to analyze the first 2-year surgical results of the PMS study of 1-level ACDR in Japan. A total of 54 patients were registered (Mobi-C, n = 24, MC group; Prestige LP, n = 30, PLP group). Preoperative neurological assessment revealed radiculopathy in 31 patients (57.4%) and myelopathy in 15 patients (27.8%). Preoperative radiological assessment classified the disease category as disc herniation in 15 patients (27.8%), osteophyte in 6 patients (11.1%), and both in 33 patients (61.1%). The postoperative follow-up rates at 6 weeks, 6 months, 1 year, and 2 years after ACDR were 92.6%, 87.0%, 83.3%, and 79.6%, respectively. In both groups, patients' neurological condition improved significantly after surgery. Radiographic assessment revealed loss of mobility at the surgical level in 9.5% of patients in the MC group and in 9.1% of patients in the PLP group. No secondary surgeries at the initial surgical level and no serious adverse events were observed in either group. The present results suggest that 1-level ACDR is safe, although medium-to long-term follow-up is mandatory to further verify the validity of ACDR for Japanese patients.

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Section: Discussionmentioning

confidence: 96%

Safety and Validity of Anterior Cervical Disc Replacement for Single-level Cervical Disc Disease: Initial Two-year Follow-up of the Prospective Observational Post-marketing Surveillance Study for Japanese Patients

Takami

Hara

et al. 2022

Neurol. Med. Chir.(Tokyo)

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“…Preserving as much cervical mobility as possible and reducing the incidence of adjacent segment disease (ASD) are crucial considerations for neurosurgeons in surgical planning. In Frontiers in Bioengineering and Biotechnology frontiersin.org contrast to anterior cervical discectomy and fusion (ACDF), artificial cervical disc replacement (ACDR) can maintain a certain mobility of the cervical spine after surgery and has gained widespread attention and clinical applications (Coban et al, 2021). The construction of ball-and-socket joints, whether metal-to-metal or metal-to-plastic, is regarded as the key to ensuring mobility for artificial cervical discs and is currently the mainstream design (Choi et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…The construction of ball-and-socket joints, whether metal-to-metal or metal-to-plastic, is regarded as the key to ensuring mobility for artificial cervical discs and is currently the mainstream design ( Choi et al, 2017 ). However, the excessive ROM and rigid connection between the metal articular surfaces brought about by the design concept could increase the pressure on the facet joints ( Lee et al, 2011 ), with long-term overload leading to surgical segment degeneration and ASD, which increases the risks of prosthesis subsidence and dislocation ( Coban et al, 2021 ). Heterotopic ossification associated with prosthesis implantation is also considered a challenging problem that cannot be ignored ( Dey et al, 2017 ; Wang et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?

Liu

Zhu

et al. 2022

Front. Bioeng. Biotechnol.

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Objective: To evaluate the biological function of cervical subtotal discectomy prosthesis (CSDP) implantation in a non-human primate model.Methods: A CSDP was tested for cytocompatibility and osseointegration capacity before implantation in non-human primates. Subsequently, the CSDP was improved based on three-dimensional CT measurements of the non-human primate cervical spine. Eight cynomolgus monkeys were selected for removal of the intervertebral disc and lower endplate of the C5/6 segment to complete the model construction for CSDP implantation. In 18-month follow-up, physiological indices, radiology, and kinematics were assessed to estimate the biological function of the CSDP in non-human primates, including biosafety, osseointegration, and biomechanics.Results: Co-cultured with the CSDP constituent titanium alloy (Ti6Al4V-AO), the mouse embryo osteoblast precursor cell MC3T3-E1 obtained extended adhesion, remarkable viability status, and cell proliferation. After implantation in the mouse femur for 28 days, the surface of Ti6Al4V-AO was covered by a large amount of new cancellous bone, which formed further connections with the femur cortical bone, and no toxicity was detected by blood physiology indices or histopathology. After completing implantation in primate models, no infection or osteolysis was observed, nor was any subsidence or displacement of the CSDP observed in CT scans in the 18-month follow-up. In particular, the interior of the cervical vertebra fixation structure was gradually filled with new trabecular bone, and the CSDP had achieved fixation and bony fusion in the vertebral body at 1 year post-operation. Meanwhile, no signs of inflammation, spinal cord compression, adjacent segment degeneration, or force line changes were observed in subsequent MRI observations. Moreover, there were no pathological changes of the joint trajectory, joint motion range, stride length, or the stance phase ratio revealed in the kinematics analysis at 3, 6, 12, or 18 months after CSDP implantation.Conclusion: We successfully designed a new cervical subtotal discectomy prosthesis and constructed an excellent non-human primate implantation model for the evaluation of subtotal disc replacement arthroplasty. Furthermore, we demonstrated that CSDP had outstanding safety, osseointegration capacity, and biomechanical stability in a non-human primate model, which might be a new choice in the treatment of cervical disc diseases and potentially change future outcomes of degenerative cervical diseases.

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“…The mechanical test also proved that the durability can reach a normal person for more than 50 years (Shikinami et al, 2010). The current clinical research on the alternative treatment of intervertebral disc degeneration is mainly total disc replacement, and different artificial disc materials have a certain impact on the clinical efficacy (Coban et al, 2021). At the same time, the high recurrence rate and unclear risk factors for secondary surgery also limit the development of surgery (Perfetti et al, 2021).…”

Section: Preclinical Study Of Biomaterials For Intervertebral Disk Repairmentioning

confidence: 99%

Advances and Prospects in Biomaterials for Intervertebral Disk Regeneration

Bai

Tian

et al. 2021

Front. Bioeng. Biotechnol.

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Low-back and neck-shoulder pains caused by intervertebral disk degeneration are highly prevalent among middle-aged and elderly people globally. The main therapy method for intervertebral disk degeneration is surgical intervention, including interbody fusion, disk replacement, and diskectomy. However, the stress changes caused by traditional fusion surgery are prone to degeneration of adjacent segments, while non-fusion surgery has problems, such as ossification of artificial intervertebral disks. To overcome these drawbacks, biomaterials that could endogenously regenerate the intervertebral disk and restore the biomechanical function of the intervertebral disk is imperative. Intervertebral disk is a fibrocartilaginous tissue, primarily comprising nucleus pulposus and annulus fibrosus. Nucleus pulposus (NP) contains high water and proteoglycan, and its main function is absorbing compressive forces and dispersing loads from physical activities to other body parts. Annulus fibrosus (AF) is a multilamellar structure that encloses the NP, comprises water and collagen, and supports compressive and shear stress during complex motion. Therefore, different biomaterials and tissue engineering strategies are required for the functional recovery of NP and AF based on their structures and function. Recently, great progress has been achieved on biomaterials for NP and AF made of functional polymers, such as chitosan, collagen, polylactic acid, and polycaprolactone. However, scaffolds regenerating intervertebral disk remain unexplored. Hence, several tissue engineering strategies based on cell transplantation and growth factors have been extensively researched. In this review, we summarized the functional polymers and tissue engineering strategies of NP and AF to endogenously regenerate degenerative intervertebral disk. The perspective and challenges of tissue engineering strategies using functional polymers, cell transplantation, and growth factor for generating degenerative intervertebral disks were also discussed.

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Metal-on-metal versus metal-on-plastic artificial discs in two-level anterior cervical disc replacement: a meta-analysis with follow-up of 5 years or more

Cited by 8 publications

References 28 publications

Safety and Validity of Anterior Cervical Disc Replacement for Single-level Cervical Disc Disease: Initial Two-year Follow-up of the Prospective Observational Post-marketing Surveillance Study for Japanese Patients

Safety and Validity of Anterior Cervical Disc Replacement for Single-level Cervical Disc Disease: Initial Two-year Follow-up of the Prospective Observational Post-marketing Surveillance Study for Japanese Patients

Cervical subtotal discectomy prosthesis validated in non-human primate model: A novel artificial cervical disc replacement concept?

Advances and Prospects in Biomaterials for Intervertebral Disk Regeneration

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