Skip to main content
Top
Published in: European Spine Journal 8/2014

01-08-2014 | Original Article

Clinical and radiographic outcomes of dynamic cervical implant replacement for treatment of single-level degenerative cervical disc disease: a 24-month follow-up

Authors: Lei Wang, Yue-ming Song, Li-ming Liu, Hao Liu, Tao Li

Published in: European Spine Journal | Issue 8/2014

Login to get access

Abstract

Purpose

To determine the role of dynamic cervical implant (DCI) replacement for single-level degenerative cervical disc disease in Chinese patients.

Methods

Thirty patients with single-level degenerative cervical disc disease were prospectively enrolled between April 2010 and August 2010 (12 women, 18 men; mean age 56.5 years). All patients underwent anterior cervical decompression, DCI replacement, clinical and radiological assessments preoperatively and at 1, 6, 12, and 24 months postoperatively, and Japanese Orthopaedic Association (JOA), Visual Analogue Scale (VAS), Neck Disability Index (NDI), and Short Form 36 (SF-36) scores. Lateral neutral radiographs provided the intervertebral space height. Lateral dynamic radiographs were taken to measure the range of motion (ROM) of the cervical spine and functional spinal unit (FSU) of the treated segment. We compared the amount of motion of the adjacent vertebral endplate and the intrinsic motion of the implant and calculated a correlation analysis.

Results

DCI showed good clinical and radiographic outcomes. At the final follow-up, JOA, VAS, NDI, and SF-36 average scores improved significantly. The intervertebral space height increased slightly after operation and was maintained during follow up. The ROM of the cervical spine and FSU decreased at early follow-up, but recovered to the preoperative level within 1–2 years. There was a high index of linear correlation between the motion of the adjacent vertebral endplate and the intrinsic motion of the implant.

Conclusions

DCI provided elastic dynamic stability for the targeted segment, and restored and sustained intervertebral space height and ROM of the cervical spine.
Literature
1.
go back to reference Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Jt Surg Am 40-A(3):607–624 Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Jt Surg Am 40-A(3):607–624
2.
go back to reference Cauthen JC, Kinard RE, Vogler JB, Jackson DE, DePaz OB et al (1998) Outcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients. Spine 23:188–192PubMedCrossRef Cauthen JC, Kinard RE, Vogler JB, Jackson DE, DePaz OB et al (1998) Outcome analysis of noninstrumented anterior cervical discectomy and interbody fusion in 348 patients. Spine 23:188–192PubMedCrossRef
3.
go back to reference Samartzis D, Shen FH, Lyon C, Phillips M, Goldberg EJ, An HS (2004) Does rigid instrumentation increase the fusion rate in onelevel anterior cervical discectomy and fusion? Spine J 4:636–643PubMedCrossRef Samartzis D, Shen FH, Lyon C, Phillips M, Goldberg EJ, An HS (2004) Does rigid instrumentation increase the fusion rate in onelevel anterior cervical discectomy and fusion? Spine J 4:636–643PubMedCrossRef
4.
go back to reference Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, An HS (2002) Biomechanical study on the effect of cervical spine fusion on adjacent level intradiscal pressure and segmental motion. Spine 27:2431–2434PubMedCrossRef Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, An HS (2002) Biomechanical study on the effect of cervical spine fusion on adjacent level intradiscal pressure and segmental motion. Spine 27:2431–2434PubMedCrossRef
5.
go back to reference Wigfield CC, Gill S, Nelson R, Langdon I, Metcalf N, Robertson J (2002) Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg 96(1 suppl):17–21PubMed Wigfield CC, Gill S, Nelson R, Langdon I, Metcalf N, Robertson J (2002) Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg 96(1 suppl):17–21PubMed
6.
go back to reference Sugawara T, Itoh Y, Hirano Y, Higashiyama N, Mizoi K (2009) Long-term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages. Acta Neurochir (Wien) 151(4):303–309CrossRef Sugawara T, Itoh Y, Hirano Y, Higashiyama N, Mizoi K (2009) Long-term outcome and adjacent disc degeneration after anterior cervical discectomy and fusion with titanium cylindrical cages. Acta Neurochir (Wien) 151(4):303–309CrossRef
7.
go back to reference Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Jt Surg Am 81:519–528 Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Jt Surg Am 81:519–528
8.
go back to reference Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B et al (2004) Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 17:79–85PubMedCrossRef Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B et al (2004) Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 17:79–85PubMedCrossRef
9.
go back to reference Kulkarmi V, Rajshekhar V, Raghuram L (2004) Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy magnetic resonance imaging study evidence. J Neurosurg 100(1 Suppl Spine):2–6 Kulkarmi V, Rajshekhar V, Raghuram L (2004) Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy magnetic resonance imaging study evidence. J Neurosurg 100(1 Suppl Spine):2–6
10.
go back to reference Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC (2005) Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine 30(10):1165–1172PubMedCrossRef Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC (2005) Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine 30(10):1165–1172PubMedCrossRef
11.
go back to reference Matgé G, Eif M, Herdmann J (2009) Dynamic cervical implant (DCITM): clinical results from an international multicenter prospective study. Paradig Spine 1:1–3 Matgé G, Eif M, Herdmann J (2009) Dynamic cervical implant (DCITM): clinical results from an international multicenter prospective study. Paradig Spine 1:1–3
12.
go back to reference DiAngelo DJ, Roberston JT, Metcalf NH, Mcvay BJ, Davis RC (2003) Biomechanical testing of an artificial cervical joint and an anterior cervical plate. J Spinal Disord Tech 16:314–323PubMedCrossRef DiAngelo DJ, Roberston JT, Metcalf NH, Mcvay BJ, Davis RC (2003) Biomechanical testing of an artificial cervical joint and an anterior cervical plate. J Spinal Disord Tech 16:314–323PubMedCrossRef
13.
go back to reference Robertson JT, Papadopoulos SM, Traynelis VC (2005) Assessment of adjacent segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study. J Neurosurg Spine 3:417–423PubMedCrossRef Robertson JT, Papadopoulos SM, Traynelis VC (2005) Assessment of adjacent segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study. J Neurosurg Spine 3:417–423PubMedCrossRef
14.
16.
go back to reference Robertson J, Metcalf N (2004) Long-term outcome after implantation of the Prestige I disc in an end-stage indication: 4-year results form a pilot study. Neurosurg Focus 17(3):E10PubMedCrossRef Robertson J, Metcalf N (2004) Long-term outcome after implantation of the Prestige I disc in an end-stage indication: 4-year results form a pilot study. Neurosurg Focus 17(3):E10PubMedCrossRef
17.
go back to reference Lafuente J, Casey AT, Petzold A, Brew S (2005) The Bryan cervical disc prosthesis as an alternative to arthrodesis in the treatment of cervical spondylosis: 46 consecutive cases. J Bone Jt Surg Br 87:508–512CrossRef Lafuente J, Casey AT, Petzold A, Brew S (2005) The Bryan cervical disc prosthesis as an alternative to arthrodesis in the treatment of cervical spondylosis: 46 consecutive cases. J Bone Jt Surg Br 87:508–512CrossRef
18.
go back to reference Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 6:198–209PubMedCrossRef Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 6:198–209PubMedCrossRef
19.
go back to reference Parkinson JF, Sekhon LH (2005) Cervical arthroplasty complicated by delayed spontaneous fusion. Case report. J Neurosurg Spine 2(3):377–380CrossRef Parkinson JF, Sekhon LH (2005) Cervical arthroplasty complicated by delayed spontaneous fusion. Case report. J Neurosurg Spine 2(3):377–380CrossRef
20.
go back to reference Leung C, Casey AT, Goffin J, Kehr P, Liebig K, Lind B et al (2005) Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery 57:759–763PubMedCrossRef Leung C, Casey AT, Goffin J, Kehr P, Liebig K, Lind B et al (2005) Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery 57:759–763PubMedCrossRef
21.
go back to reference Mehren C, Suchomel P, Grochulla F, Barsa P, Sourkova P, Hradil J et al (2006) Heterotopic ossification in total cervical artificial disc replacement. Spine 31(24):2802–2806PubMedCrossRef Mehren C, Suchomel P, Grochulla F, Barsa P, Sourkova P, Hradil J et al (2006) Heterotopic ossification in total cervical artificial disc replacement. Spine 31(24):2802–2806PubMedCrossRef
22.
go back to reference Heidecke V, Burkert W, Brucke M, Rainov NG (2008) Intervertebral disc replacement for cervical degenerative disease-clinical results and functional outcome two years in patients implanted with the bryan cervical disc prosthesis. Acta Neurochir (Wein) 150:453–459CrossRef Heidecke V, Burkert W, Brucke M, Rainov NG (2008) Intervertebral disc replacement for cervical degenerative disease-clinical results and functional outcome two years in patients implanted with the bryan cervical disc prosthesis. Acta Neurochir (Wein) 150:453–459CrossRef
23.
go back to reference Welke B, Hurschler C, Packheiser A, Richter B, Daentzer D (2010) Biomechanical concept of a novel dynamic cervical implant: first biomechanical comparison among fusion, TDR, and dynamic stabilization. Eur spine 19:1963–2073CrossRef Welke B, Hurschler C, Packheiser A, Richter B, Daentzer D (2010) Biomechanical concept of a novel dynamic cervical implant: first biomechanical comparison among fusion, TDR, and dynamic stabilization. Eur spine 19:1963–2073CrossRef
24.
go back to reference Suchomel P, Jurák L, Benes V 3rd, Brabec R, Bradác O, Elgawhary S (2010) Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Eur Spine J 19(2):307–315PubMedCentralPubMedCrossRef Suchomel P, Jurák L, Benes V 3rd, Brabec R, Bradác O, Elgawhary S (2010) Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Eur Spine J 19(2):307–315PubMedCentralPubMedCrossRef
25.
go back to reference Chen J, Wang X, Bai W, Shen X, Yuan W (2012) Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Eur Spine J 21(4):674–680PubMedCentralPubMedCrossRef Chen J, Wang X, Bai W, Shen X, Yuan W (2012) Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Eur Spine J 21(4):674–680PubMedCentralPubMedCrossRef
26.
go back to reference Guérin P, Obeid I, Bourghli A, Meyrat R, Luc S, Gille O et al (2012) Heterotopic ossification after cervical disc replacement: clinical significance and radiographic analysis. Prospect study. Acta Orthop Belg 78(1):80–86 Guérin P, Obeid I, Bourghli A, Meyrat R, Luc S, Gille O et al (2012) Heterotopic ossification after cervical disc replacement: clinical significance and radiographic analysis. Prospect study. Acta Orthop Belg 78(1):80–86
27.
go back to reference Yi S, Shin DA, Kim KN, Choi G, Shin HC, Kim KS (2013) The predisposing factors for the heterotopic ossification after cervical artificial disc replacement. Spinal J 13(9):1048–1054CrossRef Yi S, Shin DA, Kim KN, Choi G, Shin HC, Kim KS (2013) The predisposing factors for the heterotopic ossification after cervical artificial disc replacement. Spinal J 13(9):1048–1054CrossRef
28.
go back to reference Ahrengart L, Sahlin K, Lindgren U (1987) Myositis ossification after total hip replacement and perioperative muscle ischemia. J Arthroplast 2:65–69CrossRef Ahrengart L, Sahlin K, Lindgren U (1987) Myositis ossification after total hip replacement and perioperative muscle ischemia. J Arthroplast 2:65–69CrossRef
Metadata
Title
Clinical and radiographic outcomes of dynamic cervical implant replacement for treatment of single-level degenerative cervical disc disease: a 24-month follow-up
Authors
Lei Wang
Yue-ming Song
Li-ming Liu
Hao Liu
Tao Li
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 8/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3180-7

Other articles of this Issue 8/2014

European Spine Journal 8/2014 Go to the issue