Cervical Disc Replacement in Patients With and Without Previous Adjacent Level Fusion Surgery

Phillips, Frank M.; Allen, Todd R.; Regan, John J.; Albert, Todd J.; Cappuccino, Andrew; DeVine, John G.; Ahrens, Jeanette E.; Hipp, John A.; McAfee, Paul C.

doi:10.1097/brs.0b013e31819b061c

Cited by 77 publications

(39 citation statements)

References 38 publications

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“…The inclusion/exclusion age range was 18-60 years. The common indications and contraindications were similar to those used in other US IDE clinical studies [3,26]. Postoperatively, patients were mobilized with a soft-collar for 3 days under surveillance of a physical therapist.…”

Section: Patient Samplementioning

confidence: 99%

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

et al. 2012

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Introduction To better understand cervical kinematics following cervical disc replacement (CDR), the in vivo behavior of a minimally constrained CDR was assessed. Methods Radiographic analysis of 19 patients undergoing a 1-level CDR from C4-5 to C6-7 (DISCOVER, DepuySpine, USA) was performed. Neutral-lateral and flexionextension radiographs obtained at preop, postop and late follow-up were analyzed for segmental angle and global angle (GA C2-7). Flexion-extension range of motion was analyzed using validated quantitative motion analysis software (QMAÒ, Medical Metrics, USA). The FSU motion parameters measured at the index and adjacent levels were angular range of motion (ROM), translation and center of rotation (COR). Translation and COR were normalized to the AP dimension of the inferior endplate of the caudal vertebra. All motion parameters, including COR, were compared with normative reference data. Results The average patient age was 43.5 ± 7.3 years. The mean follow-up was 15.3 ± 7.2 months. C2-7 ROM was 35.9°± 15.7°at preop and 45.4°± 13.6°at follow-up (Dp\ .01). Based on the QMA at follow-up, angular ROM at the CDR level measured 9.8°± 5.9°and translation was 10.1 ± 7.8 %. Individuals with higher ROM at the CDR level had increased translation at that level (p \ .001, r = 0.97), increased translation and ROM at the supra-adjacent level (p \ .001, r = .8; p = .005, r = .6). There was a strong interrelation between angular ROM and translation at the supra-adjacent level (p \ .001, r = .9) and caudal-adjacent level (p\.001, r = .9). The location of the COR at the CDRand supra-adjacent levels was significantly different for the COR-X (p \ .001). Notably, the COR-Y at the CDR level was significantly correlated with the extent of CDR-level translation (p = .02, r = .6). Shell angle, which may be influenced by implant size and positioning had no impact on angular ROM but was correlated with COR-X (p = .05, r = -.6) and COR-Y (p = .04, r = -.5). Conclusion The COR is an important parameter for assessing the ability of non-constrained CDRs to replicate the normal kinematics of a FSU. CDR size and location, both of which can impact shell angle, may influence the amount of translation by affecting the location of the COR. Future research is needed to show how much translation is beneficial concerning clinical outcomes and facet loading.

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Section: Patient Samplementioning

confidence: 99%

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

et al. 2012

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“…Primer ve füzyon sonrası gelişen KSH'nı takiben yapılan artroplastilerin kısa dönem sonuçlarının karşılaştırıldığı serilerde, her iki grup arasında benzer klinik sonuçlar bulunmuştur. [26,27] Tablo 1. KSH etiyolojisinde risk faktörleri …”

Section: Servi̇kal Di̇sk Artroplasti̇si̇ (Sda) Ve Komşu Segment Hastaliğiunclassified

Servikal spinal füzyonla ilişkili komşu segment hastalığının önlenmesi ve tedavisi

Kaya¹,

Dikici²

2017

TOTBID

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“…Benefits in terms of stresses reduction on adjacent segments may be more important for multilevel procedure than for mono-segmental surgery considering that loss of mobility is greater when multiple segments are fused. Recently, some authors reported clinical experience of TDR inserted at two levels or above previous fusion [20][21][22] and their results suggested that clinical outcomes after multilevel TDR were at least as good as those observed for single-level TDR. Although multilevel TDR could be an attractive option to treat multilevel cervical disc disease, there is still no consensus about the different treatment options: multilevel ACDF, multilevel TDR or hybrid constructs (arthrodesis combined with TDR).…”

Section: Introductionmentioning

confidence: 99%

Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation

et al. 2011

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Introduction The purpose of this experimental study was to analyse cervical spine kinematics after 1-level and 2-level total disc replacement (TDR) and compare them with those after anterior cervical arthrodesis (ACA) and hybrid construct. Kinematics and intradiscal pressures were also investigated at adjacent levels. Methods Twelve human cadaveric spines were evaluated in different testing conditions: intact, 1 and 2-level TDR (Discocerv TM , Scient'x/Alphatec), 1 and 2-level ACA, and hybrid construct. All tests were performed under load control protocol by applying pure moments loading of 2 N m in flexion/ extension (FE), axial rotation (AR) and lateral bending (LB). Results Reduction of ROM after 1-level TDR was only significant in LB. Implantation of additional TDR resulted in significant decrease of ROM in AR at index level. A second TDR did not affect kinematics of the previously implanted TDR in FE, AR and LB. One and 2-level arthrodesis caused significant decrease of ROM in FE, AR and LB at the index levels. No significant changes in ROM were observed at adjacent levels except for 1-level arthrodesis in FE and hybrid construct in AR. When analysis was done under the displacement-control concept, we found that 1 and 2-constructs increased adjacent levels contribution to global ROM C3-C7 during FE and that IDP at superior adjacent level increased by a factor of 6.7 and 2.3 for 2-level arthrodesis and hybrid constructs, respectively. Conclusion Although 1-and 2-level TDR restored only partially native kinematics of the cervical spine, these constructs generated better biomechanical conditions than arthrodesis at adjacent levels limiting contribution of these segments to global ROM and reducing the amount of their internal stresses.

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Cervical Disc Replacement in Patients With and Without Previous Adjacent Level Fusion Surgery

Cited by 77 publications

References 38 publications

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement

Servikal spinal füzyonla ilişkili komşu segment hastalığının önlenmesi ve tedavisi

Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation

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