Qualitative and quantitative assessment of degeneration of cervical intervertebral discs and facet joints

Walraevens, Joris; Liu, Baoge; Meersschaert, Joke; Demaerel, Philippe; Delye, Hans; Depreitere, Bart; Sloten, Jos Vander; Goffin, Jan

doi:10.1007/s00586-009-0887-y

Cited by 23 publications

(47 citation statements)

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“…The analysis of adjacent-segment degeneration was derived from a quantitative analysis of disc height and an independent radiologist's subjective assessments of osteophytes and endplate sclerosis based on a previously described qualitative and quantitative assessment of cervical disc degeneration. 47 The assessment of disc height, extent of osteophyte formation, and degree of endplate sclerosis is common to published degeneration grading systems.…”

Section: Methodsmentioning

confidence: 99%

Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up

Coric

Nunley

Guyer

et al. 2011

SPI

315

227

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Object Cervical total disc replacement (CTDR) represents a relatively novel procedure intended to address some of the shortcomings associated with anterior cervical discectomy and fusion (ACDF) by preserving motion at the treated level. This prospective, randomized, multicenter study evaluates the safety and efficacy of a new metal-on-metal CTDR implant (Kineflex|C) by comparing it with ACDF in the treatment of single-level spondylosis with radiculopathy. Methods The study was a prospective, randomized US FDA Investigational Device Exemption (IDE) pivotal trial conducted at 21 centers across the US. The primary clinical outcome measures included the Neck Disability Index (NDI), visual analog scale (VAS) scores, and a composite measure of clinical success. Patients were randomized to CTDR using the Kineflex|C (SpinalMotion, Inc.) cervical artificial disc or ACDF using structural allograft and an anterior plate. Results A total of 269 patients were enrolled and randomly assigned to either CTDR (136 patients) or to ACDF (133 patients). There were no significant differences between the CTDR and ACDF groups when comparing operative time, blood loss, length of hospital stay, or the reoperation rate at the index level. The overall success rate was significantly greater in the CTDR group (85%) compared with the ACDF group (71%) (p = 0.05). In both groups, the mean NDI scores improved significantly by 6 weeks after surgery and remained significantly improved throughout the 24-month follow-up (p < 0.0001). Similarly, the VAS pain scores improved significantly by 6 weeks and remained significantly improved through the 24-month follow-up (p < 0.0001). The range of motion (ROM) in the CTDR group decreased at 3 months but was significantly greater than the preoperative mean at 12- and 24-month follow-up. The ROM in the ACDF group was significantly reduced by 3 months and remained so throughout the follow-up. Adjacent-level degeneration was also evaluated in both groups from preoperatively to 2-year follow-up and was classified as none, mild, moderate, or severe. Preoperatively, there were no significant differences between groups when evaluating the different levels of adjacent-level degeneration. At the 2-year follow-up, there were significantly more patients in the ACDF group with severe adjacent-level radiographic changes (p < 0.0001). However, there were no significant differences between groups in adjacent-level reoperation rate (7.6% for the Kineflex|C group and 6.1% for the ACDF group). Conclusions Cervical total disc replacement allows for neural decompression and clinical results comparable to ACDF. Kineflex|C was associated with a significantly greater overall success rate than fusion while maintaining motion at the index level. Furthermore, there were significantly fewer Kineflex|C patients showing severe adjacent-level radiographic changes at the 2-year follow-up. These results from a prospective, randomized study support that Kineflex|C CTDR is a viable alternative to ACDF in select patients with cervical radiculopathy.

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Section: Methodsmentioning

confidence: 99%

Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up

Coric

Nunley

Guyer

et al. 2011

SPI

315

227

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“…The angle of cer vical lordosis was set as a positive value and kyphosis as a negative value. The degree of degeneration at each cervical level was assessed on the neutralposition lateral radiograph using the scoring system for cervical disc degeneration present ed by Walraevens et al 25 This scoring system was shown to be reliable and objective in a previous study, with excel lent intrarater agreement (intraclass correlation coefficient [ICC] = 0.86, range 0.75-0.93) and interrater agreement (ICC = 0.78, range 0.64-0.88). The system classifies the severity of disc degeneration from no degeneration to severe degeneration (score range 0-9) on the basis of 3 variables: height loss, anterior osteophytes, and endplate sclerosis.…”

Section: Methodsmentioning

confidence: 99%

“…7,12 A pre vious study by our team has shown the relation between the instantaneous center of rotation and cervical disc de generation in asymptomatic subjects. 14 In this study, we performed radiographic studies of the cervical spines of 212 asymptomatic volunteers and demonstrated the effect of disc degeneration on segmental ROM, based on a scor ing system for cervical disc degeneration, 25 which can be used to assess the degree of cervical disc degeneration for 3 independent variables.…”

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confidence: 99%

Are the standard parameters of cervical spine alignment and range of motion related to age, sex, and cervical disc degeneration?

Liu

Hoof³

et al. 2015

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OBJECT The aims of this study were 1) to establish the standard parameters of alignment and total and segmental range of motion (ROM) of the cervical spine in the asymptomatic population, and 2) to identify factors that influence cervical ROM and alignment. METHODS The authors measured 636 standard cervical lateral, flexion, and extension plain radiographs of 212 asymptomatic volunteers. The relationship between cervical alignment and total ROM was assessed with simple linear regression. Multivariate linear regression was used to determine the effect of the influential factors on cervical alignment and total and segmental ROM. RESULTS The mean value for C2–7 cervical alignment was 21.40° ± 12.15°, and the mean value for total ROM was 63.59° ± 15.37°. Sex was a significant factor in cervical alignment, total ROM, and segmental ROM for C2–3 and C5–6 (p < 0.05). Age had a significant negative association with both the total ROM and all of the segmental ROM measurements (p < 0.05). Cervical disc degeneration at the level of interest had a significant negative association with C4–5, C5–6, and C6–7 ROM (p < 0.05). CONCLUSIONS Cervical alignment in female subjects was 2.47° lower than that in male subjects. Total ROM was 3.86° greater in female than in male subjects and decreased 6.46° for each decade of aging. Segmental ROM decreased 1.28° for each decade of aging and 2.26° for each category increase in disc degeneration at the level of interest.

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“…To our knowledge, this is the first study to investigate the laterality of CDH and to demonstrate that the frequency of left-sided CDH was significantly higher than the right one at C6-7 level, although there are a few studies demonstrating a weak correlation of the degeneration between cervical disc and facet joint [2], and that the degree of cartilage degeneration of left-side facet joints did not significantly differ from those on the right side [3]. There is controversy concerning the relationship between facet joint asymmetry and lumbar spinal degeneration [4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Discussionmentioning

confidence: 81%

Laterality of cervical disc herniation

Takahashi¹,

Yasuhara²,

Kumamoto³

et al. 2012

Eur Spine J

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Purpose Cervical disc herniation (CDH) is found more frequently at the lower cervical spine than at the upper or middle level. However, there is scarcity of data about the laterality of CDH. The aim of this study is to detect the laterality of CDH. Methods We retrospectively evaluated preoperative computed tomography myelograms and magnetic resonance images of 75 cases of CDH who underwent single level anterior cervical discectomy and fusion at C4-5, C5-6, or C6-7 levels from 2008 to 2010 in our institute. Statistical analyses were performed using the Chi-square test. Results Eleven cases were found at C4-5 level, 42 cases at C5-6 level, and 22 cases at C6-7 level. At C4-5 level, CDH was recognized at the right side in 2 cases, at the left side in 2 cases, and at the center in 7 cases. At C5-6 level, CDH was found at the right side in 20 cases and at the left side in 22 cases. At C6-7 level, CDH was found at the right side in 3 cases and at the left side in 19 cases with significantly high frequency of left-sided CDH (p \ 0.025). Conclusions In this study, it was revealed that the leftsided CDH was more frequent than the right-sided CDH at C6-7 level.

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Qualitative and quantitative assessment of degeneration of cervical intervertebral discs and facet joints

Cited by 23 publications

References 0 publications

Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up

Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up

Are the standard parameters of cervical spine alignment and range of motion related to age, sex, and cervical disc degeneration?

Laterality of cervical disc herniation

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