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01-04-2018 | Original Paper

Outcomes of the Bryan cervical disc replacement: fifteen year follow-up

Authors: Vincent Pointillart, Jean-Etienne Castelain, Pierre Coudert, Derek Thomas Cawley, Olivier Gille, Jean-Marc Vital

Published in: International Orthopaedics | Issue 4/2018

Abstract

Background

The CTDR is a technique that treats cervical disc degenerative disease. Initial shorter-term studies showed good clinical and radiological results.

Purpose

To assess the clinical and radiological results of Bryan cervical disc replacement (Medtronic Sofamor Danek Inc., Memphis, TN) at 15-year follow-up.

Results

This prospective study included 20 patients who underwent 22 CTDR, comprising a single-level procedure in 14 patients and two-level procedures in six patients. The mean follow-up period was 15.5 years. The mean age at the intervention was 46.2 years (range: 26–65 years). Two patients needed re-operation for recurrence of symptoms. According to Odom’s criteria, 80.0% (16 of 20 patients) had excellent outcomes, VAS for neck pain was 2.6 (0–10), for shoulder/arm pain it was 1.8 (0–7), and NDI at the final follow up was 14.9. The SF-12 PCS was 46.1, and SF-12 MCS was 51.9. Mobility was maintained in 15 of the 22 (68.2%) operated segments, range of motion (ROM) of prostheses were 9° ± 3.9° (range 4–15°). The prostheses were positioned in kyphosis in 14 of 22 levels (63.6%). There was a positive correlation between the kyphosis of the prosthesis and the occurrence of heterotopic ossification (HO), and their grade (ρ = 0.36, CI 95%[−0.68; 0.07]). HO had developed at 12 of the 22 levels (54.5%) and upper adjacent segment degeneration in 11 of 18 of patients (64.7%). All these results were not significantly different to outcomes at 8 years follow-up.

Conclusion

In a cohort of 20 patients with 15-year clinical and radiological follow-up, the Bryan CTDR has demonstrated a sustained clinical improvement and implant mobility over time, despite a moderate progression of degenerative processes at the prosthetic and adjacent levels.

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Title: Outcomes of the Bryan cervical disc replacement: fifteen year follow-up
Authors: Vincent Pointillart
Jean-Etienne Castelain
Pierre Coudert
Derek Thomas Cawley
Olivier Gille
Jean-Marc Vital
Publication date: 01-04-2018
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 4/2018
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3745-2

At a glance: The STEP trials

Springer Medicine

Outcomes of the Bryan cervical disc replacement: fifteen year follow-up

Abstract

Background

Purpose

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purpose

Results

Conclusion

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Correction to: Ambroise Paré (1510–1590): on the diagnosis and treatment of shoulder dislocations