EFFECTIVENESS OF CERVICAL DISC REPLACEMENT FOR CERVICAL MYELOPATHY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YAN Dongxue ¹ , XIAO Zengming ² , SHEN Chong ¹ , HUANG Yongji ¹

1Department of Spinal Surgery, the Affiliated Hospital of Guilin Medical University, Guilin Guangxi, 541001, P.R.China;;
2Department of Spinal and Joint Surgery, the First Affiliated Hospital of Guangxi Medical University.;

Corresponding author：

Keywords：

Cervical disc replacement; Cervical myelopathy; Cervical disc protrusion

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ObjectiveTo evaluate the effectiveness of cervical disc replacement for cervical myelopathy. MethodsBetween October 2006 and October 2008, 20 patients (26 segments) with cervical myelopathy underwent single-level (14 segments) or bi-level (6 segments) cervical disc replacement. There were 8 males and 12 females with an average age of 46 years (range, 26-65 years). The disease duration ranged 2-18 months (mean, 7 months). The effectiveness was evaluated using visual analogue scale (VAS) score, cervical range of motion (ROM), and the Odom et al. criteria. Heterotopic ossification (HO), osteophyte formation, and prosthesis loosening were observed. ResultsAll incisions healed by first intention, with no severe complication. Twenty patients were followed up 30-48 months (mean, 34 months). At 28 months after operation, according to Odom et al. criteria, the results were excellent in 17 cases and good in 3 cases. The VAS scores of the neck, shoulder, and upper limb were significantly improved when compared with preoperative scores (P lt; 0.05). At 30 months after operation, X-ray films showed that 20 replaced segments were mobile and ROM was (10.6 ± 4.5)°, showing no significant difference (P gt; 0.05) when compared with that of upper adjacent segment (10.8 ± 3.7)° and lower adjacent segment (7.5 ± 4.2)°. HO occurred in 10 cases (13 segments). No displacement, subsidence, or loosening occurred except 1 case of retrodisplacement of the prosthesis. ConclusionCervical disc replacement can obtain good effectiveness. It can maintain normal cervical ROM and physiological curvature. But it needs further long-term follow-up to evaluate the function and the influence on the adjacent segments.

Citation： YAN Dongxue,XIAO Zengming,SHEN Chong,HUANG Yongji. EFFECTIVENESS OF CERVICAL DISC REPLACEMENT FOR CERVICAL MYELOPATHY. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1058-1061. doi: Copy

1.	刘忠军. 脊柱外科手术操作与技巧. 北京: 人民卫生出版社, 2009: 26.
2.	Odom GL, Finney W, Woodhall B. Cervical disc lesions. J Am Med Assoc, 1958, 166(1): 23-28.
3.	McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
4.	农鲁明, 周栋, 徐南伟, 等. 人工颈椎间盘置换术治疗颈椎病的中期疗效观察. 中国脊柱脊髓杂志, 2010, 20(7): 567-571.
5.	郭隆升, 马晓春, 付鹏, 等. Bryan人工椎间盘置换术治疗颈椎病的初步探讨. 中国现代医学, 2010, 48(8): 144-148.
6.	Goffin J, van Loon J, van Calenbergh F, et al. A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan cervical disc prosthesis. J Neurosurg Spine, 2010, 12(3): 261-269.
7.	Cheng L, Nie L, Zhang L, et al. Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomized study. Int Orthop, 2008, 33(5): 1037-1351.
8.	Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic, changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
9.	Wenger M, van Hoonacker P, Zachee B, et al. Bryan cervical disc prosthesis: preservation of function over time. J Clin Neurosci, 2009, 16(2): 220-225.
10.	刘文华, 朱兵, 刘晓伟, 等. 单节段Bryan人工颈椎间盘置换术后异位骨化的发生率和疗效观察. 中国修复重建外科杂志, 2012, 26(6): 699-702.
11.	Leung C, Casey AT, Goffin J, et al. Clinical significance of heteroptopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(4): 759-763.
12.	Mehran C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
13.	Garrido BJ, Taha TA, Sasso RC. Clinical outcomes of Bryan cervical disc arthroplasty: a prospective, randomized, controlled, single site trial with48-month follow-up. J Spinal Disord Tech, 2010, 23 (6): 367-371.
14.	Rama KR, Vendittoli PA, Ganapathi M, et al. Heterotopic ossification after surface arthroplasty and total hip arthroplasty: a randomized study. J Arthroplasty , 2009, 24(2): 256-262.
15.	Murrey D, Janssen M, Delamarter R, et al. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J, 2009, 9(4): 275-286.
16.	Wu SK, Kuo LC, Lan HC, et al. The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension. Eur Spine J, 2007, 16(9): 1435-1444.
17.	Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg (Am), 1999, 81(4): 519-528.
18.	DiAngelo DJ, Roberston JT, Metcalf NH, et al. Biomechanical testing of an artificial cervical joint and an anterior cervical plate. J Spinal Disord Tech, 2003, 16(4): 314-323.
19.	Faizan A, Goel VK, Garfin SR, et al. Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation. Eur Spine J, 2012, 21 Suppl 5: 653-662.
20.	Zechmeister I, Winkler R, Mad P. Artificial total disc replacement versus fusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.
21.	谢华, 徐南伟, 农鲁明, 等. Prodisc-C人工颈椎间盘置换术治疗中老年颈椎病的疗效. 江苏医学, 2011, 37(6): 691-693.

1. 刘忠军. 脊柱外科手术操作与技巧. 北京: 人民卫生出版社, 2009: 26.
2. Odom GL, Finney W, Woodhall B. Cervical disc lesions. J Am Med Assoc, 1958, 166(1): 23-28.
3. McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
4. 农鲁明, 周栋, 徐南伟, 等. 人工颈椎间盘置换术治疗颈椎病的中期疗效观察. 中国脊柱脊髓杂志, 2010, 20(7): 567-571.
5. 郭隆升, 马晓春, 付鹏, 等. Bryan人工椎间盘置换术治疗颈椎病的初步探讨. 中国现代医学, 2010, 48(8): 144-148.
6. Goffin J, van Loon J, van Calenbergh F, et al. A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan cervical disc prosthesis. J Neurosurg Spine, 2010, 12(3): 261-269.
7. Cheng L, Nie L, Zhang L, et al. Fusion versus Bryan Cervical Disc in two-level cervical disc disease: a prospective, randomized study. Int Orthop, 2008, 33(5): 1037-1351.
8. Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic, changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
9. Wenger M, van Hoonacker P, Zachee B, et al. Bryan cervical disc prosthesis: preservation of function over time. J Clin Neurosci, 2009, 16(2): 220-225.
10. 刘文华, 朱兵, 刘晓伟, 等. 单节段Bryan人工颈椎间盘置换术后异位骨化的发生率和疗效观察. 中国修复重建外科杂志, 2012, 26(6): 699-702.
11. Leung C, Casey AT, Goffin J, et al. Clinical significance of heteroptopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(4): 759-763.
12. Mehran C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
13. Garrido BJ, Taha TA, Sasso RC. Clinical outcomes of Bryan cervical disc arthroplasty: a prospective, randomized, controlled, single site trial with48-month follow-up. J Spinal Disord Tech, 2010, 23 (6): 367-371.
14. Rama KR, Vendittoli PA, Ganapathi M, et al. Heterotopic ossification after surface arthroplasty and total hip arthroplasty: a randomized study. J Arthroplasty , 2009, 24(2): 256-262.
15. Murrey D, Janssen M, Delamarter R, et al. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J, 2009, 9(4): 275-286.
16. Wu SK, Kuo LC, Lan HC, et al. The quantitative measurements of the intervertebral angulation and translation during cervical flexion and extension. Eur Spine J, 2007, 16(9): 1435-1444.
17. Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg (Am), 1999, 81(4): 519-528.
18. DiAngelo DJ, Roberston JT, Metcalf NH, et al. Biomechanical testing of an artificial cervical joint and an anterior cervical plate. J Spinal Disord Tech, 2003, 16(4): 314-323.
19. Faizan A, Goel VK, Garfin SR, et al. Do design variations in the artificial disc influence cervical spine biomechanics? A finite element investigation. Eur Spine J, 2012, 21 Suppl 5: 653-662.
20. Zechmeister I, Winkler R, Mad P. Artificial total disc replacement versus fusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.
21. 谢华, 徐南伟, 农鲁明, 等. Prodisc-C人工颈椎间盘置换术治疗中老年颈椎病的疗效. 江苏医学, 2011, 37(6): 691-693.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF CERVICAL DISC REPLACEMENT FOR CERVICAL MYELOPATHY

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