Effect of heterotopic ossification on cervical motion following Prestige artificial cervical disc replacement / 解剖学报

[Abstract] Objective To analyze the effect of heterotopic ossification(HO) on the postoperative segmental range of motion(ROM)after Prestige artificial cendcal disc replacement, and to explore the related factors leading to the formation of heterotopic ossification after artificial cendcal disc replacement. Methods We recruited of 66 patients who had Prestige artificial cendcal disc replacement from January 2014 to January 2018 in Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University were retrospectively reviewed. To evaluate cendcal spine X-ray, the replacement segment ROM was measured in picture, and the occurrence of HO was defined by the McAfee' s classification. The Wilcoxon signed rank test was used to analyze the relationship between heterotopic ossification formation and replacement segment ROM,the t test was used to analyze the influence between heterotopic ossification grading and replacement segment ROM. Nine clinical factors including age, gender, bod)' mass index(BMI), number of replacement segments, preoperative ligament ossification, the preoperative disc height ratio of the target level and its adjacent level, preoperative mobility of replacement segments, postoperative mobility of replacement segments, whether to use nonsteroidal autiinflammatory drugs (NSAIDs) during perioperative period. The correlation between these nine clinical factors and the occurrence of postoperative HO was evaluated with logistic regression analysis. Results The occurrence rate of HO was 34. 8% in last follow-up. The replacement segmental ROM of the heterotopic ossification group was significantly smaller than that of the non-ectopic ossification group, and the difference was statistically significant (P<0. 05),and the McAfee grade IH-IV group was significantly less than the McAfee grade I-H group, and the difference was statistically significant (P < 0. 05). Correlation analysis showed that preoperative and postoperative ROM of the replacement segment presented statistical correlation (P < 0. 05). Furthennore analysis of ROC curve showed that heterotopic ossification was more likely to occur when the degree of ROM of the replacement segment

Research progresses of artificial cervical disc structure, material and in vitro biomechanics / 中国组织工程研究

10.3969/j.issn.2095-4344.2013.26.019

Resultados tempranos de la artroplastía cervical utilizando Prodisc-C / Early results of cervical artroplasty with Prodisc-C

Introducción. La utilización del disco artificial cervical (artroplastía) es una técnica relativamente nueva, que se presenta como una alternativa a la ya clásica cirugía de discectomía y fusión que se usa para las lesiones degenerativas de la columna cervical subaxial. El desarrollo de esta técnica obedece a la necesidad de encontrar un diseño que permita reproducir de manera fisiológica la función del disco intervertebral. Material y Método. Entre los meses de julio de 2005 y junio de 2007, en el Servicio deNeurocirugía de la Clínica Güemes de Luján, se realizaron 35 artroplastías cervicales en 27 pacientes. La edad promedio fue de 43,4 años, con un rango entre el paciente más joven 28 años y 54 el mayor. Los pacientes fueron evaluados en el preoperatorio y a los 45 días, 3, 6 y 12 meses Resultados. Observamos una gran mejoría tanto con la evaluación del cuestionario Neck Disability Index (NDI) en los primeros controles como con la escala analógica visual (VAS). Esta mejoría, si bien se mantuvo hasta gran parte de nuestra etapa de control, al año mostró un ligero aumento de la sintomatología, pero sin salir de los parámetros que consideramos como satisfactorios. Conclusión. Para pacientes jóvenes con historia de dolor cervical y/o radicular de 3 meses de evolución o más, el empleo del ProDisc- C, por sus beneficios, se presenta como una excelente opción para el tratamiento de la hernia de disco cervical.

Introduction. The use of an artificial cervical disc is a new technique that can replace the classical discectomy and fusion for lesion in the lower cervical spine. The purpose of this design is to reproduce the function of the intervertebral disc. Method. Between July 2004 and June 2007, 35 cervical arthroplasties were performed at Clinica Guemes, Lujan. 27 patients underwent a single or double disc replacement. The average age was 4A��3.4 years (range 28-54). The patients were evaluated 45, 90, 180 and 365 days after surgery. The patients were evaluated using Neck Disability Index (NDI) and Visual Analogic Scale (VAS). Results. A steady improvement could be observed in all patients tested by both scales. Conclusion. The use of ProDisc-C in young patients appear to be an excellent option for the treatment of cervical disc herniation.

Comparative Analysis of Cervical Arthroplasty Using Mobi-C(R) and Anterior Cervical Discectomy and Husion Using the Solis(R) -Cage

OBJECTIVE: Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. METHODS: We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. RESULTS: Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs. 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. CONCLUSION: Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.

Clinical study of Bryan prosthetic disc in the treatment of ossification of posterior longitudinal ligament of cervical spine / 中国矫形外科杂志

[Objective] To observe the clinical effect of Bryan cervical prosthetic disc in treating ossification of posterior longitudinal ligament(OPLL)of cervical spine.[Method]From October 2005 to June 2007,15 localized OPLL patients were treated surgically by cervical arthroplasty using Bryan disc prosthesis.JOA score and radiological study were performed before and after operation.The range of movement(ROM)of replaced level were investigated postoperatively.[Result]Neurological deficit was alleviated in all patients.All patients were followed up at least 6 months,JOA score increased from an average of 8.5 to 15.8.Replaced segment restored the normal ROM in flexion and extension.[Conclusion]Cervical arthroplasty using Bryan disc prosthesis can achieve good clinical outcome in treating localized OPLL of cervical spine;and the normal ROM can be retained in the replaced level.