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Are Controversial Issues in Cervical Total Disc Replacement Resolved or Unresolved?: A Review of Literature and Recent Updates
Asian Spine Journal ; : 178-192, 2018.
Artículo en Inglés | WPRIM | ID: wpr-739237
ABSTRACT
Since the launch of cervical total disc replacement (CTDR) in the early 2000s, many clinical studies have reported better outcomes of CTDR compared to those of anterior cervical discectomy and fusion. However, CTDR is still a new and innovative procedure with limited indications for clinical application in spinal surgery, particularly, for young patients presenting with soft disc herniation with radiculopathy and/or myelopathy. In addition, some controversial issues related to the assessment of clinical outcomes of CTDR remain unresolved. These issues, including surgical outcomes, adjacent segment degeneration (ASD), heterotopic ossification (HO), wear debris and tissue reaction, and multilevel total disc replacement (TDR) and hybrid surgeries are a common concern of spine surgeons and need to be resolved. Among them, the effect of CTDR on patient outcomes and ASD is theoretically and clinically important; however, this issue remains disputable. Additionally, HO, wear debris, multilevel TDR, and hybrid surgery tend to favor CTDR in terms of their effects on outcomes, but the potential of these factors for jeopardizing patients' safety postoperatively and/or to exert harmful effects on surgical outcomes in longer-term follow-up cannot be ignored. Consequently, it is too early to determine the therapeutic efficacy and cost-effectiveness of CTDR and will require considerable time and studies to provide appropriate answers regarding the same. For these reasons, CTDR requires longer-term follow-up data.
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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Pronóstico / Radiculopatía / Enfermedades de la Médula Espinal / Columna Vertebral / Vértebras Cervicales / Estudios de Seguimiento / Osificación Heterotópica / Discectomía / Degeneración del Disco Intervertebral / Reeemplazo Total de Disco Tipo de estudio: Estudio observacional / Estudio pronóstico Límite: Femenino / Humanos Idioma: Inglés Revista: Asian Spine Journal Año: 2018 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Pronóstico / Radiculopatía / Enfermedades de la Médula Espinal / Columna Vertebral / Vértebras Cervicales / Estudios de Seguimiento / Osificación Heterotópica / Discectomía / Degeneración del Disco Intervertebral / Reeemplazo Total de Disco Tipo de estudio: Estudio observacional / Estudio pronóstico Límite: Femenino / Humanos Idioma: Inglés Revista: Asian Spine Journal Año: 2018 Tipo del documento: Artículo