Cervical disc arthroplasty: tips and tricks

Makhni, Melvin C.; Osorio, Joseph A.; Park, Paul J.; Lombardi, Joseph M.; Riew, K. Daniel

doi:10.1007/s00264-018-4259-2

Cited by 11 publications

(21 citation statements)

References 32 publications

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“…The perfectly inserted Caspar pins can be used as markers for midline for where the implant would be inserted. 41 In addition, intraoperative radiographic confirmation is performed during each step of the implantation process. 42 All these procedures guarantee a proper position of the implanted artificial discs.…”

Section: Discussionmentioning

confidence: 99%

Association of cervical sagittal alignment with adjacent segment degeneration and heterotopic ossification following cervical disc replacement with Prestige-LP disc

Wang

Meng

Líu

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: Cervical sagittal balance plays important roles in transmitting the load of the head and maintaining global spinal balance. This study aimed to identify the association of cervical sagittal alignment with adjacent segment degeneration (ASD) and heterotopic ossification (HO) after Prestige-LP cervical disc replacement (CDR). Methods: We enrolled 132 patients who underwent one-level Prestige-LP CDR with 2–10 years of follow-up. Cervical sagittal alignment parameters, including the degree of C2–C7 lordosis (CL), functional spinal unit angle (FSUA), sagittal vertical axis (SVA),, and T1 slope (T1s), were measured. ASD and HO were evaluated at the last follow-up. Unpaired t tests and logistic regression analysis were used to identify the associations of cervical sagittal alignment with ASD and HO. Results: We found that patients who developed ASD showed significantly lower FSUA (2.1° vs. −1.4°, p < 0.001) and T1s values (28.4° vs. 25.5°, p = 0.029) after surgery. Similarly, the postoperative CL was significantly better in patients without ASD or HO (18.0° vs. 14.4°, p = 0.043). The decrease in the T1s at the last follow-up was significantly larger in the patients with ASD (−11.0° vs. −3.2°, p = 0.003), HO (−6.7° vs. −2.7°, p = 0.050), and ASD or HO (−7.0° vs. −0.8°, p < 0.001) than in those without ASD or HO. Multivariate logistic regression analysis showed that both the FSUA and T1s are associated with ASD and that the degree of CL is associated with postoperative complications. Conclusion: The results imply that maintaining cervical sagittal alignment after Prestige-LP CDR is important.

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Section: Discussionmentioning

confidence: 99%

Association of cervical sagittal alignment with adjacent segment degeneration and heterotopic ossification following cervical disc replacement with Prestige-LP disc

Wang

Meng

Líu

et al. 2020

J Orthop Surg (Hong Kong)

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“…Journal of Orthopaedic Surgery 29(1S) all contribute to device failure, and arthroplasty should not be performed when these pathologies are encountered. 42 Case illustration: A 40 y.o. male had undergone a C6-7 CDA by another surgeon but had persistent left C7 radiculopathy.…”

Section: Smentioning

confidence: 99%

“…To prevent anterior bone spur formation, Riew et al reported that meticulous hemostasis and minimizing the risk of hematoma also helped to decrease the levels of circulating growth factors promoting fusion. 42 They recommended continuing to perform irrigation until every little speck of bone dust is gone. 42 In addition, they recommend denuding the periosteum 1 cm above and below the prosthesis with monopolar electrocautery and placing bone wax on the bone.…”

Section: Complicationsmentioning

confidence: 99%

“…11,44,45 Riew et al demonstrated that a wellfitting prosthesis that covers the majority of the endplate diameter can help to prevent HO. 42,46 Osteolysis is another frequent but not-well recognized complication of CDA (Figure 5). A recent systematic review article found that the reported incidence of asymptomatic osteolysis was as high as 64%, with the majority of papers showing an incidence between 44% and 64%.…”

Section: Complicationsmentioning

confidence: 99%

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Cervical disc arthroplasty: What we know in 2020 and a literature review

Shin

Kim

Son

et al. 2021

J Orthop Surg (Hong Kong)

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Cervical disc arthroplasty (CDA) is a safe and effective option to improve clinical outcomes (e.g., NDI, VAS, and JOA) in degenerative cervical disc disease and compressive myelopathy. CDA’s two main purported benefits have been that it maintains physiologic motion and thereby minimizes the biomechanical stresses placed on adjacent segments as compared to an ACDF. CDA might reduce the degeneration of adjacent segments, and the need for adjacent-level surgery. Reoperation rates of CDA have been reported to range from 1.8% to 5.4%, with a minimum 5-year follow-up. As the number of CDA procedures performed continues to increase, the need for revision surgery is also likely to increase. When performed skillfully in appropriate patients, CDA is an effective surgical technique to optimize clinical outcomes and radiological results. This review may assist surgical decision-making and enable a more effective and safer implementation of cervical arthroplasty for cervical degenerative disease.

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“…In the meantime, Joaquim et al [3] consider Bstudies of level I of evidence attesting to the safety and efficacy of cervical disc arthroplasty (CDA) in the management of cervical spondylotic disease (CSD) for one or two levels degenerative disease^. From the same team, Makhni et al [4] show interesting techniques about how to improve CDA's performance and outcomes. Traumatic aetiology is quite frequent in case of CDH.…”

Section: Cervical Disc Herniationsmentioning

confidence: 99%