Document Detail


Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up.
MedLine Citation:
PMID:  20035357     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cervical total disc replacement (CTDR) aims to decrease the incidence of adjacent segment disease through motion preservation in the operated disc space. Ongoing data collection and increasing number of studies describing heterotopic ossification (HO) resulting in decreased mobility of implants, forced us to carefully evaluate our long-term clinical and morphological results of patients with CTDR. We present the first 54 consecutive patients treated with 65 ProdiscC prostheses during a 12-month period (2/2004-3/2005). All patients signed an informed consent and were included in prospective long-term study approved by hospital ethical committee. The 1- and 2-year follow-up analysis were available for all patients included and 4-year results for 50 patients (60 implants). Clinical (neck disability index-NDI, visual analog scale-VAS) and radiological follow-up was conducted at 1-, 2- and 4-years after the procedure. The Mehren/Suchomel modification of McAfee scale was used to classify the appearance of HO. Mean preoperative NDI was 34.5%, VAS for neck pain intensity 4.6 and VAS for arm pain intensity 5.0. At 1-, 2- and 4-year follow-up, the mean NDI was 30.7, 27.2, and 30.4, mean VAS for neck pain intensity 2.5, 2.1 and 2.9 and mean VAS for arm pain intensity pain 2.2, 1.9 and 2.3, respectively. Significant HO (grade III) was present in 45% of implants and segmental ankylosis (grade IV) in another 18% 4 years after intervention. This finding had no clinical consequences and 92% of patients would undergo the same surgery again. Our clinical results (NDI, VAS) are comparable with fusion techniques. Although, advanced non-fusion technology is used, a significant frequency of HO formation and spontaneous fusion in cervical disc replacement surgery must be anticipated during long-term follow-up.
Authors:
Petr Suchomel; Lubomír Jurák; Vladimír Benes; Radim Brabec; Ondrej Bradác; Shamel Elgawhary
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-12-25
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  19     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-16     Completed Date:  2010-07-15     Revised Date:  2011-07-22    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  307-15     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Regional Hospital Liberec, Liberec, Czech Republic.
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MeSH Terms
Descriptor/Qualifier:
Adult
Ankylosis / etiology,  pathology,  physiopathology
Cervical Vertebrae / pathology,  surgery*
Disability Evaluation
Diskectomy / adverse effects*
Female
Follow-Up Studies
Head Movements / physiology
Humans
Internal Fixators / adverse effects
Intervertebral Disk Displacement / complications*,  pathology,  surgery*
Male
Middle Aged
Neck Pain / etiology,  pathology,  physiopathology
Ossification, Heterotopic / etiology*,  pathology,  physiopathology
Pain Measurement
Postoperative Complications / etiology*,  pathology,  physiopathology
Range of Motion, Articular / physiology
Recurrence
Spinal Fusion / adverse effects
Stress, Mechanical
Time
Time Factors
Weight-Bearing / physiology
Comments/Corrections

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