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Published in: European Spine Journal 10/2019

Open Access 01-10-2019 | Neck Pain | Original Article

Clinical and radiological evaluation of cervical disc arthroplasty with 5-year follow-up: a prospective study of 384 patients

Authors: T. Dufour, J. Beaurain, J. Huppert, P. Dam-Hieu, P. Bernard, J. P. Steib

Published in: European Spine Journal | Issue 10/2019

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Abstract

Background

Cervical total disc replacement was developed to avoid known complications of cervical fusion. The purpose of this paper was to provide 5-year follow-up results of an ongoing prospective study after implantation of cervical disc prosthesis.

Methods

Three hundred and eighty-four patients were treated using Mobi-C cervical disc (Zimmer Biomet, Troyes, France) and included in a prospective multicentre study. Routine clinical and radiological examinations were reported preoperatively and postoperatively with up to 5-year follow-up. Complications and revision surgeries were also explored.

Results

Results at 5 years showed significant improvement in all clinical outcomes (NDI, VAS for arm and neck pain, SF-36 PCS and MCS). Motion at index level increased significantly from 6.0° preoperatively to 8.0°, and 72.1% of the implanted segments were still mobile (referring to threshold of ROM > 3°). Proximal and distal adjacent discs showed no significant change in average motion 5 years after surgery compared to baseline. Ossification resulting in complete fusion was observed in 16.4% of the implanted segments. Distal and proximal adjacent disc degeneration occurred in 42.2% and 39.1% of patients, respectively. Complications rate was 8.9%, and 1.5% of the patients had reoperation at the index level. Surgery rate of adjacent discs was 2.9%. An increased percentage of working patients and a decrease in medication consumption were observed. At 5 years, 93.3% patients were satisfied regarding the overall outcome.

Conclusions

In this study, favourable 5-year follow-up clinical and radiological outcomes were observed with a low rate of adjacent level surgery.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.
Appendix
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Literature
2.
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 (3):607–624CrossRef 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 (3):607–624CrossRef
5.
go back to reference Matsumoto M, Okada E, Ichihara D, Watanabe K, Chiba K, Toyama Y, Fujiwara H, Momoshima S, Nishiwaki Y, Iwanami A, Ikegami T, Takahata T, Hashimoto T (2010) Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten-year magnetic resonance imaging follow-up study. Spine 35(1):36–43. https://doi.org/10.1097/BRS.0b013e3181b8a80d CrossRefPubMed Matsumoto M, Okada E, Ichihara D, Watanabe K, Chiba K, Toyama Y, Fujiwara H, Momoshima S, Nishiwaki Y, Iwanami A, Ikegami T, Takahata T, Hashimoto T (2010) Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten-year magnetic resonance imaging follow-up study. Spine 35(1):36–43. https://​doi.​org/​10.​1097/​BRS.​0b013e3181b8a80d​ CrossRefPubMed
16.
go back to reference McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disorders Tech 16(4):384–389CrossRef McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disorders Tech 16(4):384–389CrossRef
18.
go back to reference Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502CrossRef Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502CrossRef
19.
go back to reference Symposium on Population Studies in Relation to Chronic Rheumatic Diseases R, Ball J, Jeffrey MR, Kellgren JH, Council for International Organizations of Medical S, University of Manchester. Department of R (1963) The epidemiology of chronic rheumatism; Volume 2: Atlas of standard radiographs of arthritis. Blackwell Scientific Publications, Oxford Symposium on Population Studies in Relation to Chronic Rheumatic Diseases R, Ball J, Jeffrey MR, Kellgren JH, Council for International Organizations of Medical S, University of Manchester. Department of R (1963) The epidemiology of chronic rheumatism; Volume 2: Atlas of standard radiographs of arthritis. Blackwell Scientific Publications, Oxford
23.
go back to reference Loumeau TP, Darden BV, Kesman TJ, Odum SM, Van Doren BA, Laxer EB, Murrey DB (2016) A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF). Eur Spine J 25(7):2263–2270. https://doi.org/10.1007/s00586-016-4431-6 CrossRefPubMed Loumeau TP, Darden BV, Kesman TJ, Odum SM, Van Doren BA, Laxer EB, Murrey DB (2016) A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF). Eur Spine J 25(7):2263–2270. https://​doi.​org/​10.​1007/​s00586-016-4431-6 CrossRefPubMed
26.
go back to reference Radcliff K, Coric D, Albert T (2016) Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial. J Neurosurg Spine 25(2):213–224. https://doi.org/10.3171/2015.12.SPINE15824 CrossRefPubMed Radcliff K, Coric D, Albert T (2016) Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial. J Neurosurg Spine 25(2):213–224. https://​doi.​org/​10.​3171/​2015.​12.​SPINE15824 CrossRefPubMed
28.
go back to reference Vaccaro A, Beutler W, Peppelman W, Marzluff JM, Highsmith J, Mugglin A, DeMuth G, Gudipally M, Baker KJ (2013) Clinical outcomes with selectively constrained SECURE-C cervical disc arthroplasty: two-year results from a prospective, randomized, controlled, multicenter investigational device exemption study. Spine 38(26):2227–2239. https://doi.org/10.1097/BRS.0000000000000031 CrossRefPubMed Vaccaro A, Beutler W, Peppelman W, Marzluff JM, Highsmith J, Mugglin A, DeMuth G, Gudipally M, Baker KJ (2013) Clinical outcomes with selectively constrained SECURE-C cervical disc arthroplasty: two-year results from a prospective, randomized, controlled, multicenter investigational device exemption study. Spine 38(26):2227–2239. https://​doi.​org/​10.​1097/​BRS.​0000000000000031​ CrossRefPubMed
29.
go back to reference Wigfield C, 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 C, 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
31.
37.
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(4):519–528CrossRef 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(4):519–528CrossRef
Metadata
Title
Clinical and radiological evaluation of cervical disc arthroplasty with 5-year follow-up: a prospective study of 384 patients
Authors
T. Dufour
J. Beaurain
J. Huppert
P. Dam-Hieu
P. Bernard
J. P. Steib
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Keyword
Neck Pain
Published in
European Spine Journal / Issue 10/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-019-06069-z

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