Mid-term efficacy of Prestige LP cervical disc arthroplasty for single-level cervical spondylotic myelopathy / 局解手术学杂志

ABSTRACT

AbstarctObjective To evaluate mid-term efficacy and complications of Prestige LP cervical disc arthroplasty ( CDA) for treatment of single-level cervical spondylotic myelopathy .Methods Retrospectively analyzed the clinical data of 29 patients who underwent Prestige LP cervical disc arthroplasty from June 2009 to December 2013 and were followed up for 2 to 6 years.Among them, there were 19 males and 10 females, and the average age was (45.4 ±7.6)years old (ranged from 28 to 58 years old).Cardinal symptom of spinal compression occured in 20 cases of them,and nerve root compression occured in the other 9 cases.Clinical symptoms and functional outcomes were evaluated with Japanese Orthopaedic Association(JOA) scores,neck and arm visual analog scale(VAS) scores,and Neck Disability Index(NDI).Oerpation segmental range of motion(ROM) were evaluated with follow-up dynamic X-ray.Displacement,subsidence of the prosthesis,heterotopic ossifi-cation(HO) and other complications were also investigated .Results The 29 patients were followed up for 24 to 66 months,(35.5 ±10.4) months averagely .At the final follow-up,the JOA score,NDI,Neck-VAS and Arm-VAS were (15.62 ±1.12) points,(14.65 ±5.68)%,(1.93 ± 1.10) points,and (0.76 ±0.99) points respectively,which were significant improved compared with (12.03 ±2.23) points,(42.52 ± 16.31)%,(5.00 ±2.22) points,and (4.59 ±3.18) points preoperatively,and the differences were of statistical significance (P<0.05). The opreation segmental ROM was (7.37 ±3.11)°,which was better remained compared with (8.50 ±3.35)°before operation.After the surgery,there were 1 case of forward displacement ,3 cases of backward displacement ,1 case of subsidence of the prosthesis ,3 cases of adja-cent segment degenerations ,and 14 cases of heterotopic ossification .Conclusion The mid-term efficacy and safety of Prestige LP cervical disc arthroplasty is fine .But there is a high incidence of the prosthesis-related complications which may counteract the function of protecting the adjacent segment .Therefore,the indication,operation skills and perioperative period management of cervical disc arthroplasty are impor -tant aspects to avoid the adverse effect .