Single-level Bryan cervical disc arthroplasty: evaluation of radiological and clinical outcomes after 18 years of follow-up

Genitiempo, Maurizio; Perna, Andrea; Santagada, Domenico Alessandro; Meluzio, Maria Concetta; Proietti, Luca; Bocchi, Maria Beatrice; Logroscino, Carlo Ambrogio; Tamburrelli, Francesco Ciro

doi:10.1007/s00586-020-06486-5

Cited by 15 publications

(7 citation statements)

References 25 publications

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“…The results suggested that the occurrence of PHO did not affect the patient-reported outcomes. This is consistent with prior studies, suggesting that the satisfactory outcomes of CDR mainly depend on adequate surgical decompression [ 10 , 27 , 28 ]. Both prosthesis-endplate depth ratio and intervertebral height change were potential risk factors for the development of PHO after CDR.…”

Section: Discussionsupporting

confidence: 93%

Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

et al. 2021

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Background Heterotopic ossification (HO) is a common complication after cervical disc replacement (CDR). Biomechanical factors including endplate coverage and intervertebral disc height change may be related to HO formation. However, there is a dearth of quantitative analysis for endplate coverage, intervertebral height change and their combined effects on HO. Methods Patients who underwent single-level or two-level CDR with Prestige-LP were retrospectively reviewed. Clinical outcomes were evaluated through Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, and visual analogue scale (VAS) score. Radiological data, including the prosthesis-endplate depth ratio, intervertebral height change, posterior heterotopic ossification (PHO) and angular parameters, were collected. Logistic regression analysis was used to identify the potential risk factors. Receiver operating characteristic curves were plotted and the cut-off values of each potential factors were calculated. Results A total of 138 patients with 174 surgical segments were evaluated. Both the prosthesis-endplate depth ratio (P < 0.001) and post-operative disc height change (P < 0.001) were predictive factors for PHO formation. The area under the curve (AUC) of the prosthesis-endplate depth ratio, disc height change and their combined effects represented by the combined parameter (CP) were 0.728, 0.712 and 0.793, respectively. The risk of PHO significantly increased when the prosthesis-endplate depth ratio < 93.77% (P < 0.001, OR = 6.909, 95% CI 3.521–13.557), the intervertebral height change ≥ 1.8 mm (P < 0.001, OR = 5.303, 95% CI 2.592–10.849), or the CP representing the combined effect < 84.88 (P < 0.001, OR = 10.879, 95% CI 5.142–23.019). Conclusions Inadequate endplate coverage and excessive change of intervertebral height are both potential risk factors for the PHO after CDR. Endplate coverage less than 93.8% or intervertebral height change more than 1.8 mm would increase the risk of PHO. The combination of these two factors may exacerbate the non-uniform distribution of stress in the bone-implant interface and promote HO development.

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Section: Discussionsupporting

confidence: 93%

Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

et al. 2021

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“…However, the statistical analysis of the MRI data did not reveal the relevant deterioration of adjacent segment degeneration based on our 5-step grading system. This is in contrast to the long-term study performed by Genitiempo et al who assessed the grade of segment degeneration using the Pfirrmann grading system 30 . Two reasons might add to this different finding.…”

Section: Discussionmentioning

confidence: 72%

“…Also, it should be stated that the mobility of the CDA prosthesis might contribute to degeneration as well. An 80% range of motion rate for CDA has been reported 10 years after implantation 27 , 31 with a decrease to 56% after 18 years of follow-up 32 . In theory, loss of mobility should increase the stress on the adjacent segment which then could accelerate degeneration as well.…”

Section: Discussionmentioning

confidence: 96%

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Long-term follow-up MRI shows no hastening of adjacent segment degeneration following cervical disc arthroplasty

Burkhardt

Baumann

Simgen

et al. 2022

Sci Rep

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Cervical disc arthroplasty is an established procedure, but studies with data on long-term clinical outcome, reoperation for symptomatic adjacent segment degeneration (sASD), and degenerative changes based on MRI findings are rare. Thus, a file review was performed and patients with complete documentation of neurological status at preoperative, postoperative, 12 month, 3–4 years follow-up including surgical reports for reoperation with a minimum follow-up of 9 years were included. Final follow-up assessment included a physical examination, assessment of pain levels, Odoms criteria, Neck disability index. The degeneration of each cervical segment at preoperative and at final follow-up was assessed using an MRI. Forty-six out of 68 included patients participated, the mean follow-up was 11 (range 9–15) years, at which 71.7% of patients were free of arm pain, 52.2% of patients were free of neck pain, 63% of patients had no sensory dysfunction, and full motor strength was noted in 95.6% of patients. The clinical success rate was 76.1%, the mean NDI was 12%. Overall repeated procedure rate was 17%, the reoperation rate for sASD was 9%, and removal of CDA was performed in 4%. MRI showed progressive degeneration but no significant changes of SDI from preoperative to final follow-up.

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“…The Bryan cervical disc (Medtronic Sofamor Danek, Memphis, TN, USA), with its ability to simulate physiological kinematics, was once one of the most widely used artificial cervical discs in cervical spine surgery. Satisfactory clinical outcomes have been shown in 10- [16], 15-[17], and 18-year [18] follow-up studies for Bryan ACDR. However, detailed postoperative kinematics analysis of mid-to long-term follow-up is needed, and the factors that may affect the location of COR at the operated level remain to be determined.…”

Section: Introductionmentioning

confidence: 99%

Mid-long-term follow-up of operated level kinematics after single-level artificial cervical disc replacement with Bryan disc

Feng

Xiong

et al. 2022

J Orthop Surg Res

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Objective Evaluation of the mid-long-term kinematics of single-level Bryan artificial cervical disc replacement (ACDR) in vivo by analyzing the center of rotation (COR) at the operated level. Methods A retrospective analysis was conducted using data collected from 38 patients who underwent single-level Bryan ACDR from January 2010 to March 2013. Radiological parameters including range of motion (ROM), lordosis angle, translation, and COR were obtained. Clinical outcomes were assessed based on Odom Criteria, modified Japanese Orthopedic Association (mJOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) scores. Correlations between COR and other follow-up data were discussed at the last follow-up. Results Compared with preoperative values, the last follow-up data showed that 86.84% of cases achieved good-or-excellent outcomes based on Odom criteria; Significant improvements were observed across all scales assessed for clinical outcomes (P < 0.05); Lordosis angle was significantly increased in both the overall cervical spine and the operated level (P < 0.05); ROM of the overall cervical spine, operated level, and adjacent levels was preserved (P > 0.05); There was no significant change in COR at the operated level (P > 0.05). At the last follow-up and at the operated level, COR (Y) showed negative correlations with ROM and translation (P < 0.05), but no follow-up data correlated with COR (X) were found (P > 0.05). Conclusions Satisfactory clinical and radiological outcomes were achieved 7 years or more after single-level Bryan ACDR. At the operated level, preoperative COR was maintained, probably due to replicating the physiological interrelations of COR (Y), translation, and ROM.

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Single-level Bryan cervical disc arthroplasty: evaluation of radiological and clinical outcomes after 18 years of follow-up

Cited by 15 publications

References 25 publications

Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

Long-term follow-up MRI shows no hastening of adjacent segment degeneration following cervical disc arthroplasty

Mid-long-term follow-up of operated level kinematics after single-level artificial cervical disc replacement with Bryan disc

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