The prevalence of indications and contraindications to cervical total disc replacement

Auerbach, Joshua D.; Jones, Kristofer J.; Fras, Christian I.; Balderston, Jessica R.; Rushton, Scott A.; Chin, Kingsley R.

doi:10.1016/j.spinee.2007.06.018

Cited by 148 publications

(84 citation statements)

References 31 publications

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“…Other studies have demonstrated that less than half of the patients who present to a spine surgeon's office with cervical spine complaints are candidates for a TDR based upon IDE study criteria. 39 Therefore, the generalizability of these results to patients outside of IDE study conditions may be limited. There may also be other variables that affect the outcome of TDR that were not captured in this report.…”

Section: Discussionmentioning

confidence: 99%

Long-term Evaluation of Cervical Disc Arthroplasty with the Mobi-C© Cervical Disc: A Randomized, Prospective, Multicenter Clinical Trial with Seven-Year Follow-up

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Long-term Evaluation of Cervical Disc Arthroplasty with the Mobi-C© Cervical Disc: A Randomized, Prospective, Multicenter Clinical Trial with Seven-Year Follow-up

et al. 2017

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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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“…4,19,24,38,41 Alternative treatments for adjacent-level disease include total disc arthroplasty at the adjacent level; however, arthroplasty is an option only in select patient groups. 1,25 A recent consideration since the advent of the zero-profile device (ZPD) is the placement of such implants adjacent to previously fused segments.…”

mentioning

confidence: 99%

Zero-profile hybrid fusion construct versus 2-level plate fixation to treat adjacent-level disease in the cervical spine

Healy

Sundar

Cardenas³

et al. 2014

SPI

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Object Single-level anterior cervical discectomy and fusion (ACDF) is an established surgical treatment for cervical myelopathy. Within 10 years of undergoing ACDF, 19.2% of patients develop symptomatic adjacent-level degeneration. Performing ACDF adjacent to prior fusion requires exposure and removal of previously placed hardware, which may increase the risk of adverse outcomes. Zero-profile cervical implants combine an interbody spacer with an anterior plate into a single device that does not extend beyond the intervertebral disc space, potentially obviating the need to remove prior hardware. This study compared the biomechanical stability and adjacent-level range of motion (ROM) following placement of a zero-profile device (ZPD) adjacent to a single-level ACDF against a standard 2-level ACDF. Methods In this in vitro biomechanical cadaveric study, multidirectional flexibility testing was performed by a robotic spine system that simulates flexion-extension, lateral bending, and axial rotation by applying a continuous pure moment load. Testing conditions were as follows: 1) intact, 2) C5–6 ACDF, 3) C4–5 ZPD supraadjacent to simulated fusion at C5–6, and 4) 2-level ACDF (C4–6). The sequence of the latter 2 test conditions was randomized. An unconstrained pure moment of 1.5 Nm with a 40-N simulated head weight load was applied to the intact condition first in all 3 planes of motion and then using the hybrid test protocol, overall intact kinematics were replicated subsequently for each surgical test condition. Intersegmental rotations were measured optoelectronically. Mean segmental ROM for operated levels and adjacent levels was recorded and normalized to the intact condition and expressed as a percent change from intact. A repeated-measures ANOVA was used to analyze the ROM between test conditions with a 95% level of significance. Results No statistically significant differences in immediate construct stability were found between construct Patterns 3 and 4, in all planes of motion (p > 0.05). At the operated level, C4–5, the zero-profile construct showed greater decreases in axial rotation (–45% vs –36%) and lateral bending (–55% vs –38%), whereas the 2-level ACDF showed greater decreases in flexion-extension (–40% vs –34%). These differences were marginal and not statistically significant. Adjacent-level motion was nearly equivalent, with minor differences in flexion-extension. Conclusions When treating degeneration adjacent to a single-level ACDF, a zero-profile implant showed stabilizing potential at the operated level statistically similar to that of the standard revision with a 2-level plate. Revision for adjacent-level disease is common, and using a ZPD in this setting should be investigated clinically because it may be a faster, safer alternative.

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The prevalence of indications and contraindications to cervical total disc replacement

Cited by 148 publications

References 31 publications

Long-term Evaluation of Cervical Disc Arthroplasty with the Mobi-C© Cervical Disc: A Randomized, Prospective, Multicenter Clinical Trial with Seven-Year Follow-up

Long-term Evaluation of Cervical Disc Arthroplasty with the Mobi-C© Cervical Disc: A Randomized, Prospective, Multicenter Clinical Trial with Seven-Year Follow-up

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

Zero-profile hybrid fusion construct versus 2-level plate fixation to treat adjacent-level disease in the cervical spine

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