Clinic Therapeutic Effect of Bryan Artificial Disc Single Level Replacement on Cervical Disc Degenerative Diseases_West China Medical Journal

Authors：

SHI Rui ¹ ,  LIU Hao ¹ , DING Chen ¹ , HU Tao ¹ , LI Tao ¹ , GONG Quan ¹ , SONG Yueming ¹ , HONG Ying ²

1. Department of Orthopaedics, 2. Operating Room, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, P.R.China;

Corresponding author：

LIU Hao, Email: dr.shirui@gmail.com

Keywords：

人工椎间盘; 置换; 颈椎; 退变; 随访

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【摘要】　目的　评价Bryan人工椎间盘单节段置换治疗颈椎间盘退变性疾病的临床疗效。　方法　 2004年11月—2008年4月，21例颈椎间盘退变突出并经保守治疗无效的患者接受Bryan人工颈椎间盘单节段置换术。患者术前、术后1、6、12、18、24个月时使用颈椎功能障碍指数（neck disable index，NDI）、症状程度主观评价、疼痛视觉模拟疼痛量表（visual analogue scale，VAS）进行疗效评估，手术效果使用Odom法评价。影像学检查包括颈椎功能位X线片、颈椎CT及MRI检查。　结果　 21例患者均顺利完成椎间盘置换手术，术后随访2年。患者对症状的主观评分，颈痛VAS评分、手臂疼痛VAS评分，NDI分别由术前的（2.80±0.42）、（4.62±1.84）、（5.01±1.79）、（22.60±4.88）分下降到随访终止时的（0.20±0.42）、（1.01±0.56）、（0.82±0.24）、（4.30±1.25）分。所有患者对手术效果Odom 评级优良，8例（38.1%）自觉症状完全缓解。手术过程平均时间为（110.5±42.6） min，术中出血量平均为（166.0±108.8） mL。影像学评价见植入的人工椎间盘运动功能良好，未见颈椎不稳的表现。2例假体在术后早期轻度前移。　结论　 Bryan人工椎间盘单节段置换是治疗颈椎间盘退变性疾病的一种安全有效的方法，术后随访2年临床疗效满意。
【Abstract】　Objective　 To evaluate the clinical therapeutic effect of single segment Bryan disc replacement on cervical disc degenerative diseases.　Methods　 From November 2004 to April 2008, 21 patients who had a poor response after conservative treatment for their cervical disc degeneration underwent the single level Bryan disc replacement. Before the operation and 1, 6, 12, 18, and 24 months after the operation, all patients were evaluated by neck disable index (NDI), subjective symptom scale, visual analogue scale (VAS) and Odom score. The radiological examinations included X-ray, CT scan and MRI.　Results　 Operations were successfully executed in 21 patients. All patients had obeyed the follow-up visiting at the expected time in the next two years after the operation. Patients′ symptom scale, VAS for neck pain, VAS for arm pain, NDI were 2.80±0.42, 4.62±1.84, 5.01±1.79, and 22.60±4.88, respectively before the operation and significantly decreased to 0.20±0.42, 1.01±0.56, 0.82±0.24, and 4.30±1.25, respectively at the end of the follow-up. All patients had good or higher score of the Odom score. The ymptoms were completely relieved in eight patients (38.1%). The mean operation time was (110.5±42.6) minutes, the average blood loss was (166.0±108.8) mL. The normal motion of the artificial disc was observed. No cervical instability was observed. Two prosthesis migrated slightly.　Conclusion　 Single segmental Bryan disc replacement is safe and effective on the cervical disc degeneration. The two-year follow-up reveales a satisfied clinical outcome.

Citation： SHI Rui,LIU Hao,DING Chen,HU Tao,LI Tao,GONG Quan,SONG Yueming,HONG Ying. Clinic Therapeutic Effect of Bryan Artificial Disc Single Level Replacement on Cervical Disc Degenerative Diseases. West China Medical Journal, 2011, 26(6): 885-889. doi: Copy

1.	Bohlman HH, Emery SE, Goodfellow DB, et al. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients[J]. J Bone Joint Surg Am, 1993, 75(9): 1298-1307.
2.	Emery SE, Bohlman HH, Bolesta MJ, et al. Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy:two to seventeen-year follow-up[J]. J Bone Joint Surg Am, 1998, 80(7): 941-951.
3.	Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications[J]. Spine, 2007, 32(21): 2310-2317.
4.	Bryan VE Jr. Cervical motion segment replacement[J]. Eur Spine J, 2002, 11( Suppl 2): 92-97.
5.	Sasso RC, Best NM, Metcalf NH, et al. Motion analysis of bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial[J]. J Spinal Disord Tech, 2008, 21(6): 393-399.
6.	Sasso RC, Best NM. Cervical kinematics after fusion and bryan disc arthroplasty[J]. J Spinal Disord Tech, 2008, 21(1): 19-22.
7.	Ishihara H, Kanamori M, Kawaguchi Y, et al. Adjacent segment disease after anterior cervical interbody fusion[J]. Spine J, 2004, 4(6): 624-628.
8.	Anderson PA, Sasso RC, Riew KD. Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis[J]. Spine, 2008, 33(12): 1305-1312.
9.	Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis[J]. J Bone Joint Surg Am, 1999, 81(4): 519-528.
10.	Brodke DS, Zdeblick TA. Modified smith-robinson procedure for anterior cervical discectomy and fusion[J]. Spine, 1992, 17(Suppl 10): 427-430.
11.	Goffin J, Casey A, Kehr P, et al. Preliminary clinical experience with the Bryan cervical disc prosthesis[J]. Neurosurgery, 2002, 51(3): 840-847.
12.	Goffin J, Van Calenbergh F, Van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level[J]. Spine, 2003, 28(24): 2673-2678.
13.	Coric D, Finger F, Boltes P. Prospective randomized controlled study of the Bryan cervical disc: early clinical results from a single investigational site[J]. J Neurosurg Spine, 2006, 4(1): 31-35.
14.	Heller JG, Sasso RC, Papadopoulos SM, et al. Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial[J]. Spine (Phila Pa 1976), 2009, 34(2): 101-107.
15.	Robertson JT, Papadopoulos SM, Traynelis VC. Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study[J]. J Neurosurg Spine, 2005, 3(6): 417-423.
16.	Sasso RC, Smucker JD, Hacker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients[J]. Spine, 2007, 32(26): 2933-2942.
17.	Garrido BJ, Taha TA, Sasso RC. Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with 48-month follow-up[J]. J Spinal Disord Tech, 2010, 23(6): 367-371.
18.	农鲁明, 周栋, 徐南伟. 人工颈椎间盘置换术治疗颈椎病的中期疗效观察[J]. 中国脊柱脊髓杂志, 2010, (7): 567-571.
19.	Ren X, Wang W, Chu T, et al. The intermediate clinical outcome and its limitations of bryan cervical arthroplasty for treatment of cervical disc herniation[J]. J Spinal Disord Tech, 2011, 24(4): 221-229.
20.	田伟, 韩骁, 刘波, 等. 术前因素对人工颈椎间盘置换术中期疗效的影响[J]. 中华外科杂志, 2010, 48(2): 108-111.
21.	Chang UK, Kim DH, Lee MC, et al. Changes in adjacent-level disc pressure and facet joint force after cervical arthroplasty compared with cervical discectomy and fusion[J]. J Neurosurg Spine, 2007, 7(1): 33-39.
22.	Yang S, Wu X, Hu Y, et al. Early and intermediate follow-up results after treatment of degenerative disc disease with the Bryan cervical disc prosthesis: single-and multiple-level[J]. Spine, 2008, 33(12): 371-377.

1. 　Bohlman HH, Emery SE, Goodfellow DB, et al. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients[J]. J Bone Joint Surg Am, 1993, 75(9): 1298-1307.
2. 　Emery SE, Bohlman HH, Bolesta MJ, et al. Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy:two to seventeen-year follow-up[J]. J Bone Joint Surg Am, 1998, 80(7): 941-951.
3. 　Fountas KN, Kapsalaki EZ, Nikolakakos LG, et al. Anterior cervical discectomy and fusion associated complications[J]. Spine, 2007, 32(21): 2310-2317.
4. 　Bryan VE Jr. Cervical motion segment replacement[J]. Eur Spine J, 2002, 11( Suppl 2): 92-97.
5. 　Sasso RC, Best NM, Metcalf NH, et al. Motion analysis of bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial[J]. J Spinal Disord Tech, 2008, 21(6): 393-399.
6. 　Sasso RC, Best NM. Cervical kinematics after fusion and bryan disc arthroplasty[J]. J Spinal Disord Tech, 2008, 21(1): 19-22.
7. 　Ishihara H, Kanamori M, Kawaguchi Y, et al. Adjacent segment disease after anterior cervical interbody fusion[J]. Spine J, 2004, 4(6): 624-628.
8. 　Anderson PA, Sasso RC, Riew KD. Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis[J]. Spine, 2008, 33(12): 1305-1312.
9. 　Hilibrand AS, Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis[J]. J Bone Joint Surg Am, 1999, 81(4): 519-528.
10. 　Brodke DS, Zdeblick TA. Modified smith-robinson procedure for anterior cervical discectomy and fusion[J]. Spine, 1992, 17(Suppl 10): 427-430.
11. 　Goffin J, Casey A, Kehr P, et al. Preliminary clinical experience with the Bryan cervical disc prosthesis[J]. Neurosurgery, 2002, 51(3): 840-847.
12. 　Goffin J, Van Calenbergh F, Van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level[J]. Spine, 2003, 28(24): 2673-2678.
13. 　Coric D, Finger F, Boltes P. Prospective randomized controlled study of the Bryan cervical disc: early clinical results from a single investigational site[J]. J Neurosurg Spine, 2006, 4(1): 31-35.
14. 　Heller JG, Sasso RC, Papadopoulos SM, et al. Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial[J]. Spine (Phila Pa 1976), 2009, 34(2): 101-107.
15. 　Robertson JT, Papadopoulos SM, Traynelis VC. Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study[J]. J Neurosurg Spine, 2005, 3(6): 417-423.
16. 　Sasso RC, Smucker JD, Hacker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients[J]. Spine, 2007, 32(26): 2933-2942.
17. 　Garrido BJ, Taha TA, Sasso RC. Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with 48-month follow-up[J]. J Spinal Disord Tech, 2010, 23(6): 367-371.
18. 　农鲁明, 周栋, 徐南伟. 人工颈椎间盘置换术治疗颈椎病的中期疗效观察[J]. 中国脊柱脊髓杂志, 2010, (7): 567-571.
19. 　Ren X, Wang W, Chu T, et al. The intermediate clinical outcome and its limitations of bryan cervical arthroplasty for treatment of cervical disc herniation[J]. J Spinal Disord Tech, 2011, 24(4): 221-229.
20. 　田伟, 韩骁, 刘波, 等. 术前因素对人工颈椎间盘置换术中期疗效的影响[J]. 中华外科杂志, 2010, 48(2): 108-111.
21. 　Chang UK, Kim DH, Lee MC, et al. Changes in adjacent-level disc pressure and facet joint force after cervical arthroplasty compared with cervical discectomy and fusion[J]. J Neurosurg Spine, 2007, 7(1): 33-39.
22. 　Yang S, Wu X, Hu Y, et al. Early and intermediate follow-up results after treatment of degenerative disc disease with the Bryan cervical disc prosthesis: single-and multiple-level[J]. Spine, 2008, 33(12): 371-377.

West China Medical Journal

Clinic Therapeutic Effect of Bryan Artificial Disc Single Level Replacement on Cervical Disc Degenerative Diseases

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