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European Spine Journal

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01-03-2012 | Original Article

Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation

Authors: Cédric Barrey, Sophie Campana, Sylvain Persohn, Gilles Perrin, Wafa Skalli

Published in: European Spine Journal | Issue 3/2012

Abstract

Introduction

The purpose of this experimental study was to analyse cervical spine kinematics after 1-level and 2-level total disc replacement (TDR) and compare them with those after anterior cervical arthrodesis (ACA) and hybrid construct. Kinematics and intradiscal pressures were also investigated at adjacent levels.

Methods

Twelve human cadaveric spines were evaluated in different testing conditions: intact, 1 and 2-level TDR (Discocerv™, Scient’x/Alphatec), 1 and 2-level ACA, and hybrid construct. All tests were performed under load control protocol by applying pure moments loading of 2 N m in flexion/extension (FE), axial rotation (AR) and lateral bending (LB).

Results

Reduction of ROM after 1-level TDR was only significant in LB. Implantation of additional TDR resulted in significant decrease of ROM in AR at index level. A second TDR did not affect kinematics of the previously implanted TDR in FE, AR and LB. One and 2-level arthrodesis caused significant decrease of ROM in FE, AR and LB at the index levels. No significant changes in ROM were observed at adjacent levels except for 1-level arthrodesis in FE and hybrid construct in AR. When analysis was done under the displacement-control concept, we found that 1 and 2-constructs increased adjacent levels contribution to global ROM_C3–C7 during FE and that IDP at superior adjacent level increased by a factor of 6.7 and 2.3 for 2-level arthrodesis and hybrid constructs, respectively.

Conclusion

Although 1- and 2-level TDR restored only partially native kinematics of the cervical spine, these constructs generated better biomechanical conditions than arthrodesis at adjacent levels limiting contribution of these segments to global ROM and reducing the amount of their internal stresses.

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Title: Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation
Authors: Cédric Barrey
Sophie Campana
Sylvain Persohn
Gilles Perrin
Wafa Skalli
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 3/2012
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-011-1974-4

At a glance: The STEP trials

Springer Medicine

Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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