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Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Research article

Radiological exploration on adjacent segments after total cervical disc replacement with Prodisc-C prosthesis

Authors: Shuai Xu, Yan Liang, Fanqi Meng, Kaifeng Wang, Haiying Liu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Purpose

The relationship between upper or lower adjacent segments (UAS/LAS) and the cervical spine parameters was not clear yet. So, the purpose was to analyze range of motion (ROM), lordosis (LOR), and intervertebral disc height (IDH) of UAS and LAS before and after total cervical disc replacement (TDR) and to explore the influencing factors of cervical spine radiological parameters on adjacent segments.

Methods

A single-center retrospective study was performed on patients completing 10-year follow-up undergone TDR. As the primary outcomes, radiological parameters included UAS-ROM/LAS-ROM, UAS-LOR/LAS-LOR, and UAS-IDH/LAS-IDH. The secondary outcomes were ROM and LOR of C2–C7 and surgical levels, IDH of surgical segments, prosthesis migration, subsidence, heterotopic ossification (HO), and adjacent segment degeneration (ASD), which were measured on X-ray.

Results

UAS-ROM and LAS-ROM remained stable in follow-up periods. There was no significance on UAS-LOR or LAS-LOR between pre- and post- operation, so was UAS-IDH or LAS-IDH. UAS-ROM was larger in the segments with ASD (P < 0.001), the same to LAS-ROM (P < 0.001), and UAS-LOR was larger in segments with ASD (P = 0.02). UAS-ROM was positively correlated with C2–C7 ROM and LOR (both P < 0.001). UAS-LOR was correlated with operated-segmental LOR while LAS-LOR were in correlation with surgical segment ROM. The influencing factors of UAS-ROM were the surgical segment ROM and C2–C7 LOR. The influencing factors of UAS-LOR and LAS-LOR were LAS-ROM and UAS-ROM, respectively. The influencing factors of UAS-IDH were LAS-IDH, surgical segment IDH, and HO while that of LAS-IDH were UAS-IDH and surgical segment IDH.

Conclusions

TDR has only a little effect on the adjacent segments. There is an interaction between UAS and LAS. The maintenance on surgical segments ROM and reconstruction of IDH will benefit to adjacent segments.
Literature
2.
go back to reference Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M. ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: five-year results of a Food and Drug Administration study. Spine (Phila Pa 1976). 2013;38(3):203–9. https://doi.org/10.1097/BRS.0b013e318278eb38.CrossRef Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M. ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: five-year results of a Food and Drug Administration study. Spine (Phila Pa 1976). 2013;38(3):203–9. https://​doi.​org/​10.​1097/​BRS.​0b013e318278eb38​.CrossRef
4.
go back to reference Janssen ME, Zigler JE, Spivak JM, et al. ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am. 2015;97(21):1738–47. https://doi.org/10.2106/JBJS.N.01186.CrossRefPubMed Janssen ME, Zigler JE, Spivak JM, et al. ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration Investigational Device Exemption Study. J Bone Joint Surg Am. 2015;97(21):1738–47. https://​doi.​org/​10.​2106/​JBJS.​N.​01186.CrossRefPubMed
9.
go back to reference Duggal N, Bertagnoli R, Rabin D, Wharton N, ProDisc-C KI. An in vivo kinematic study. J Spinal Disord Tech. 2011;24(5):334–9.CrossRef Duggal N, Bertagnoli R, Rabin D, Wharton N, ProDisc-C KI. An in vivo kinematic study. J Spinal Disord Tech. 2011;24(5):334–9.CrossRef
10.
go back to reference Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81(4):519–28.CrossRef Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am. 1999;81(4):519–28.CrossRef
12.
go back to reference PC MA, Cunningham BW, Devine J, Williams E, Yu-Yahiro J. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech. 2003;16(4):384–9.CrossRef PC MA, Cunningham BW, Devine J, Williams E, Yu-Yahiro J. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech. 2003;16(4):384–9.CrossRef
13.
go back to reference Matsunaga S, Kabayama S, Yamamoto T, et al. Strain on intervertebral discs after anterior cervical decompression and fusion. Spine (Phila Pa 1976). 1999;24(7):670–5.CrossRef Matsunaga S, Kabayama S, Yamamoto T, et al. Strain on intervertebral discs after anterior cervical decompression and fusion. Spine (Phila Pa 1976). 1999;24(7):670–5.CrossRef
26.
go back to reference Laxer EB, Darden BV, Murrey DB, et al. Adjacent segment disc pressures following two-level cervical disc replacement versus simulated anterior cervical fusion. Stud Health Technol Inform. 2006;123:488–92.PubMed Laxer EB, Darden BV, Murrey DB, et al. Adjacent segment disc pressures following two-level cervical disc replacement versus simulated anterior cervical fusion. Stud Health Technol Inform. 2006;123:488–92.PubMed
Metadata
Title
Radiological exploration on adjacent segments after total cervical disc replacement with Prodisc-C prosthesis
Authors
Shuai Xu
Yan Liang
Fanqi Meng
Kaifeng Wang
Haiying Liu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1194-x

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