Document Detail


Cervical disc prosthesis in humans: first failure.
MedLine Citation:
PMID:  11242398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective preliminary trial of a cervical disc prosthesis. OBJECTIVE: To study the feasibility, efficacy in maintaining intervertebral mobility, and complications of a low-profile disc prosthesis implanted after single-level cervical discectomy. SUMMARY OF BACKGROUND DATA: Since studies reported by Baba et al, there is fear that degeneration of the intervertebral disc levels adjacent to cervical arthrodesis may be exacerbated by this arthrodesis. For this reason, several cervical prostheses have been designed as an alternative to arthrodesis. None of these prostheses, some of which are bulky, has been shown to be efficacious. METHODS: Five women and five men (average age, 36 years) underwent implantation of the present disc prosthesis after single-level discectomy. The discectomy was performed for cervical disc herniation that resulted in cervicobrachial pain for more than 3 months. None of the patients exhibited intervertebral instability on bending films. Preoperative magnetic resonance studies showed a noncontained disc herniation in all 10 patients and osteophytes in 2 of the patients. RESULTS: The cervicobrachial pain resolved in all 10 patients. Intense neck pain developed in 1 patient who underwent revision surgery to remove the prosthesis and perform an arthrodesis. Another patient developed neck pain but refused the proposed revision operation. Bending films showed mobility of the intervertebral space containing the prosthesis in both of these patients. In the 8 patients who remained pain free after the operation, lateral bending films at follow-up found no mobility of the implanted disc level. Five of these eight patients had circumferential fusion, 2 had posterior fusion, and 1 had anterior fusion. CONCLUSION: This prosthesis failed to achieve the desired effect because the intended mobility failed to persist in 8 of the 10 patients and pain developed in the other 2 patients, in whom the mobility persisted.
Authors:
V Pointillart
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Spine     Volume:  26     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-12     Completed Date:  2001-05-17     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E90-2     Citation Subset:  IM    
Affiliation:
Unité de Pathologie Rachidienne, Hôpital Pellegrin Tripode, Bordeaux Cedex, France. vincent.pointillart@chu-bordeaux.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Cervical Vertebrae* / pathology,  radiography,  surgery
Diskectomy
Feasibility Studies
Female
Humans
Intervertebral Disk Displacement / diagnosis,  surgery*
Magnetic Resonance Imaging
Male
Middle Aged
Prognosis
Prospective Studies
Prosthesis Design
Prosthesis Failure*
Prosthesis Implantation / adverse effects,  instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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