163. Unconstrained cervical disc replacements: is segmental hypermobility a concern?

Patel, Hershil; Norris, Zoe; O'Malley, Nicholas; Ashayeri, Kimberly; Balouch, Eaman; Sissman, Ethan; Maglaras, Constance; Buckland, Aaron J.

doi:10.1016/j.spinee.2021.05.191

Cited by 1 publication

(4 citation statements)

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“…36,37 Furthermore, there is a lack of consensus regarding the term hypermobility; the existing literature contains inconsistent and seemingly arbitrary definitions. [18][19][20]38 Rather, hypermobility could be defined by ROM values that alter outcomes after CDA.…”

Section: Discussionmentioning

confidence: 99%

“…The classification of cervical arthroplasty devices is complex with particular ambiguity regarding the terms unconstrained, constrained, and semiconstrained 36,37. Furthermore, there is a lack of consensus regarding the term hypermobility; the existing literature contains inconsistent and seemingly arbitrary definitions 18–20,38. Rather, hypermobility could be defined by ROM values that alter outcomes after CDA.…”

Section: Discussionmentioning

confidence: 99%

“…17 Despite these findings, concerns regarding increased motion or hypermobility after CDA have arisen, especially with unconstrained implants. [18][19][20] However, prior reports regarding hypermobility after CDA are retrospective, and there is a lack of consensus regarding what amount of motion constitutes hypermobility. Our study is a post hoc analysis of prospectively collected data from an FDA IDE randomized clinical trial comparing single-level CDA with an unconstrained device to ACDF.…”

mentioning

confidence: 99%

“…Despite these findings, concerns regarding increased motion or hypermobility after CDA have arisen, especially with unconstrained implants 18–20. However, prior reports regarding hypermobility after CDA are retrospective, and there is a lack of consensus regarding what amount of motion constitutes hypermobility.…”

mentioning

confidence: 99%

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Cervical Disk Arthroplasty and Range of Motion at 7 Years

Satin

Rogers-LaVanne

Derman

2023

Clinical Spine Surgery: A Spine Publication

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Study Design: Secondary analysis of data collected in a prospective, randomized, noninferiority Food and Drug Administration (FDA) Investigational Device Exemption (IDE) clinical trial. Objective: The objective of this study was to evaluate the impact of range of motion (ROM) following single-level cervical disk arthroplasty (CDA) on the development of radiographic adjacent level degeneration (ALD). Summary of Background Data: The rationale for CDA is that maintenance of index-level ROM will decrease adjacent level stresses and ultimately reduce the development of ALD compared with anterior cervical discectomy and fusion. However, little information is available on the impact of hypermobility on the development of ALD after CDA. Materials and Methods: Radiographic assessments were evaluated for index-level flexion-extension ROM and ALD. Continuous data was assessed using 1-way analysis of variance. The relationship between ALD progression and ROM was evaluated using χ2 tests. The α was set at 0.05. Results: More ALD progression was observed after anterior cervical discectomy and fusion than CDA (P=0.002 at the superior and P=0.049 at the inferior level). Furthermore, there was an association between ALD progression and ROM (P=0.014 at the superior level and P=0.050 at the inferior level) where patients with mid-ROM after CDA experienced the lowest frequency of ALD progression at the superior and inferior levels. Patients with the lowest and highest ROM after CDA experienced a greater increase in ALD score at the inferior level (P=0.046). Sex and age were associated with ROM groups (P=0.001 and 0.023, respectively). Conclusions: While maintenance of index-level ROM is protective after CDA, patients with the highest ROM after CDA have similar rates of ALD progression to the lowest ROM and greater increases in ALD compared with mid-ROM after CDA. High ROM after CDA may contribute to ALD progression.

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