Outcomes of the Bryan cervical disc replacement: fifteen year follow-up

Pointillart, Vincent; Castelain, Jean-Etienne; Coudert, Pierre; Cawley, Derek; Gille, Olivier; Vital, Jean-Marc

doi:10.1007/s00264-017-3745-2

Cited by 29 publications

(20 citation statements)

References 31 publications

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“…A great variety of biomechanical studies have been published about cervical arthroplasty. Most studies focus on the ROM or on changes in disc height and facet translation compared with normal individuals and with patients after ACDF, or on clinical results [10][11][12][13][14][15][16][17][18][19][20][21][22]. Several studies also investigate qualitative motion of disc prostheses [1-9], but we did not nd studies investigating how the COR after insertion of a prosthesis compares with healthy individuals, which is important because our data shows that the COR in patients with disc herniations is not at a physiological position anymore and therefore the prae-op COR cannot be used as reference:…”

Section: Discussionmentioning

confidence: 99%

In Cervical Arthroplasty Only Prostheses with Flexible Biomechanical Properties Should be Used for Achieving a Near-Physiological Motion Pattern

Mühlbauer

Tomasch

Sinz

et al. 2020

Preprint

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Background: In cervical arthroplasty, qualitative motion analysis generally investigates the position of the Center of Rotation (COR) before and after surgery. But is the prae-op COR suitable as reference? We believe that only a comparison against healthy individuals can answer whether a physiological motion pattern has been achieved. The aim of our study was to examine how the COR for flexion / extension after insertion of 3 biomechanically completely different types of disc prostheses compares to healthy volunteers, and whether and how prosthesis design contributes to a more natural or maybe even worse motion pattern.Methods: In 15 healthy volunteers MRI in flexion and in extension was taken, and the coordinates for the CORs (COR-HV) from C3 to C7 were determined. Then prae- and post-op flexion-/extension x-rays from 30 patients with a one-level disc prosthesis underwent analysis for determination of COR from C3 to C7; 10 patients who received a Bryan-, a Prestige STLP- or a Discover prosthesis were chosen, respectively. Change of post-op COR position was investigated in relation to the COR-HV.Results: The pre-operative COR is not congruent with the COR found in healthy subjects and therefore cannot be used as reference for investigation whether a disc prosthesis resembles natural motion. However, the comparison with healthy individuals shows that Prosthesis-insertion can change the coordinates of the COR to any direction in all levels from C3/4 to C6/7 regardless of the operated segment. Prostheses with flexible biomechanical properties can contribute to shift the COR towards normal, but devices with unphysiological biomechanical design, like fixed ball-socket designs, for instance, can make the motion pattern even worse.Conclusions: Even if the small cohorts in our study do not allow strong conclusions, it seems that in cervical arthroplasty, the biomechanical concept of the prosthesis has a significant impact whether a near-physiological motion pattern can be achieved or not. As it is rumor but not scientifically proofed that prosthesis-design has no influence on clinical outcome, surgeons should only choose devices with flexible biomechanical properties for disc replacement.

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Section: Discussionmentioning

confidence: 99%

In Cervical Arthroplasty Only Prostheses with Flexible Biomechanical Properties Should be Used for Achieving a Near-Physiological Motion Pattern

Mühlbauer

Tomasch

Sinz

et al. 2020

Preprint

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“…14 Besides, mismatch between the prosthesis size and intervertebral space size is another prosthesis-related cause. 6 With respect to the patient-related causes, patients' underlying diseases, such as diffuse idiopathic skeletal hyperostosis, may predispose them to bridging bone developing in a scenario in which progression to ossification would not have occurred in most individuals. 16 Several theories have been proposed to explain the risk factors of SF after CDA.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 However, spontaneous fusion (SF), may also occur at the surgical segment as a rare complication of CDA. 6 Herein, we describe a rare case of SF following CDA and review related literature to identify its courses, risk factors, and preventive measures.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Zhang

et al. 2020

JPR

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To report a rare case of spontaneous fusion (SF) following cervical disc arthroplasty (CDA), to review the related literature, and to propose a new measure to prevent it. Methods: The course of a patient with SF is described here. The potential causes, risk factors, and preventive measure of SF after CDA published in previous studies have also been reviewed and discussed. Results: A 63-year-old man presented with a 6-month history of progressive neck pain and developed left C-7 radiculopathy 4 years ago. Magnetic resonance imaging revealed disc herniation at the C6-C7 levels resulting in compression of the left C-7 nerve root. The patient underwent CDA at the C6-C7 levels, during which a PRESTIGE cervical disc device was implanted. He failed to follow-up regularly as recommended postoperatively because he was completely free from the pain in his neck and left upper limb. Four years later, he was readmitted with a 2-month history of occasional neck stiffness. Plain radiographs indicated complete radiographic fusion of the C6-C7 levels with trabecular bone bridging surrounding the cervical disc prosthesis, and dynamic imaging showed no motion. He was seen at regular follow-up visits for up to 60 months without special treatment, as his symptoms of neck stiffness were minor and his symptom has not worsened since then. Conclusion: SF after CDA is a rare condition that can be attributed to patient-or prosthesisrelated causes, and its risk factors are diverse. SF after CDA did not affect the patient's clinical outcome, and no special treatment was required for it. Practitioners should be aware of this rare complication and advise patients of the risks before performing CDA.

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“…Dejaegher et al reported that 81% of the Bryan cervical disc remained mobile with a mean ROM of 8.6° at 8-year follow-up [ 7 ]. In addition, in a 15-year follow-up study of Bryan disc arthroplasty, Pointillart et al reported that 68.2% (15/22) of the prosthesis maintained mobile with an average of 9° at final follow-up [ 18 ]. Previous studies demonstrated that both CDA and ACDF had gained good long-term clinical outcome, and most of the cervical discs remained satisfactory segmental mobility [ 5 , 6 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiographic outcomes of cervical disc arthroplasty with Prestige-LP Disc: a minimum 6-year follow-up study

Zeng

Líu

Xiao

et al. 2018

BMC Musculoskelet Disord

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BackgroundCervical disc arthroplasty (CDA) has been considered as an alternative to cervical arthrodesis in the treatment of cervical degenerative disc diseases (CDDD). The aim of this study was to assess the long-term clinical and radiographic outcomes of CDA with Prestige-LP Disc.MethodsA total of 61 patients who underwent single- or two-level CDA with Prestige-LP Disc were retrospectively investigated at a minimum of 6-year follow-up. Clinical assessments included visual analogue scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and Japanese Orthopedic Association (JOA) score. Radiological evaluations included range of motion (ROM) of the index and adjacent levels, segmental angle, cervical sagittal alignment, heterotopic ossification (HO) and adjacent segment degeneration (ASD).ResultsSignificant and maintained improvement in VAS for neck and arm, NDI and JOA were observed after a mean follow-up of 82.3 months (p < 0.001). The preoperative ROM of the index level was 9.7°, which was maintained at 2-and 4-year follow-up (9.3°, p = 0.597; 9.0°, p = 0.297), but was decreased to 8.0° at final follow-up (p = 0.019). Mobility was maintained in 80.5% (62/77) of the implanted prostheses at final follow-up. ROM of the superior and inferior adjacent segments, cervical sagittal alignment and cervical angel were all maintained. The incidence of HO was 42.9% at final follow-up, but it did not influence the clinical outcome. Radiographic ASD were detected in 29.5% of the patients. However, the incidence of symptomatic ASD was only 6.6%.ConclusionCervical disc arthroplasty with Prestige-LP Disc demonstrated a maintained and satisfactory clinical outcome at a minimal of 6-year follow-up, with majority of the prostheses remained mobile. Cervical disc arthroplasty with Prestige-LP Dis can be considered as an effective surgical method in treating CDDD.

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Outcomes of the Bryan cervical disc replacement: fifteen year follow-up

Abstract: In a cohort of 20 patients with 15-year clinical and radiological follow-up, the Bryan CTDR has demonstrated a sustained clinical improvement and implant mobility over time, despite a moderate progression of degenerative processes at the prosthetic and adjacent levels.

Cited by 29 publications

References 31 publications

In Cervical Arthroplasty Only Prostheses with Flexible Biomechanical Properties Should be Used for Achieving a Near-Physiological Motion Pattern

In Cervical Arthroplasty Only Prostheses with Flexible Biomechanical Properties Should be Used for Achieving a Near-Physiological Motion Pattern

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

Clinical and radiographic outcomes of cervical disc arthroplasty with Prestige-LP Disc: a minimum 6-year follow-up study

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