| Segmental malalignment with the Bryan Cervical Disc prosthesis--does it occur? | |
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MedLine Citation:
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PMID: 17285044 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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William R Sears; Lali H Sekhon; Neil Duggal; Owen D Williamson |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of spinal disorders & techniques Volume: 20 ISSN: 1536-0652 ISO Abbreviation: J Spinal Disord Tech Publication Date: 2007 Feb |
Date Detail:
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Created Date: 2007-02-07 Completed Date: 2007-04-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140323 Medline TA: J Spinal Disord Tech Country: United States |
Other Details:
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Languages: eng Pagination: 1-6 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Sydney NeuroSpine Clinic and Royal North Shore and Dalcross Private Hospitals, Sydney, Australia. thesears@bigpond.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biomechanics Cervical Vertebrae / pathology, physiopathology, surgery* Decompression, Surgical / adverse effects, instrumentation, methods Diskectomy / adverse effects, instrumentation, methods Female Humans Intervertebral Disk / pathology, physiopathology, surgery Intervertebral Disk Displacement / surgery* Kyphosis / etiology*, pathology, physiopathology Male Middle Aged Neck Pain / etiology, physiopathology Polyurethanes 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 Titanium Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Polyurethanes; 7440-32-6/Titanium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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