Document Detail

Segmental malalignment with the Bryan Cervical Disc prosthesis--does it occur?
MedLine Citation:
PMID:  17285044     Owner:  NLM     Status:  MEDLINE    
The early clinical results with the Bryan Cervical Disc prosthesis are encouraging but 2 recent small published series have noted postoperative radiologic kyphosis of the functional spinal unit (FSU) of 4 and 6 degrees. The current study was undertaken to accurately assess the extent of any sagittal deformity after the use of this prosthesis in a substantial, multisurgeon case series. The neutral, erect x-rays of 67 consecutive patients (88 disc levels) operated by one of 3 surgeons, were examined using manual and digital image analysis techniques for FSU sagittal angulation (lordosis), prosthesis shell angulation, segmental olisthesis, and overall cervical alignment. Measurement accuracy was confirmed using interobserver and intraobserver studies. There was a median loss of 2 degrees in FSU lordosis when compared with preoperative imaging (P<0.0001, range: 8-degree loss to 5-degree gain). A median 2 degrees of prosthesis shell kyphosis also occurred (range: 15-degree kyphosis to 12-degree lordosis) but shell angulation correlated weakly with the change in FSU lordosis (rs=0.37, P=0.001). There was a significant difference in the median loss of FSU lordosis between surgeon 1 and surgeons 2 and 3 (3.5 degrees vs. 2 degrees, P=0.005). Median olisthesis of the prosthesis shells was -0.1 mm (range: +1.5 to -2.5 mm). Median postoperative overall cervical lordosis reduced by 4 degrees (P<0.004). A small loss in median FSU lordosis was observed after insertion of the Bryan disc. The observed changes were generally small but varied among both the patients and the surgeons, suggesting that variables may exist which contribute to postoperative sagittal alignment. These are the subject of an accompanying study.
William R Sears; Lali H Sekhon; Neil Duggal; Owen D Williamson
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of spinal disorders & techniques     Volume:  20     ISSN:  1536-0652     ISO Abbreviation:  J Spinal Disord Tech     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-07     Completed Date:  2007-04-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140323     Medline TA:  J Spinal Disord Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM    
Department of Neurosurgery, Sydney NeuroSpine Clinic and Royal North Shore and Dalcross Private Hospitals, Sydney, Australia.
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MeSH Terms
Cervical Vertebrae / pathology,  physiopathology,  surgery*
Decompression, Surgical / adverse effects,  instrumentation,  methods
Diskectomy / adverse effects,  instrumentation,  methods
Intervertebral Disk / pathology,  physiopathology,  surgery
Intervertebral Disk Displacement / surgery*
Kyphosis / etiology*,  pathology,  physiopathology
Middle Aged
Neck Pain / etiology,  physiopathology
Postoperative Complications / etiology,  pathology,  physiopathology
Prostheses and Implants / adverse effects*,  standards,  statistics & numerical data*
Range of Motion, Articular / physiology
Spinal Fusion / adverse effects*,  instrumentation*,  methods
Treatment Outcome
Reg. No./Substance:
0/Polyurethanes; 7440-32-6/Titanium

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

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