EARLY EFFECTIVENESS OF Discover CERVICAL ARTIFICIAL DISC REPLACEMENT IN TREATMENT OF CERVICAL SPONDYLOSIS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

QIAN Yufeng , XUE Feng , SHENG Xiaowen , LU Jianmin , CHEN Bingqian.

Department of Orthopedics, the first People’s Hospital of Changshu, Changshu Jiangsu, 215500, P.R.China.;

Corresponding author：

Keywords：

Discover cervical artificial disc replacement; Cervical spondylosis; Prosthesis eccentricity; Range of motion of lateral bending

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【Abstract】 Objective To investigate the early effectiveness of the Discover cervical artificial disc replacement in treating cervical spondylosis. Methods Qualified for the selective standard, 24 patients with cervical spondylosis were treated between March 2010 and March 2011. Of 24 patients, 13 patients underwent anterior cervical decompression and fusion (ACDF) (ACDF group, between March 2010 and September 2010) and 11 patients underwent Discover cervical artificial disc replacement (CADR group, between September 2010 and March 2011). There was no significant difference in gender, age, disease duration, lesions typing, and affected segments between 2 groups (P gt; 0.05). The operative time, blood loss, and complications were recorded. Japanese Orthopaedic Association (JOA) scores, Neck Disability Index (NDI) scores, and Odom’s scores were used to evaluate the postoperative effectiveness. In CADR group, the cervical range of motion (ROM) in all directions, and prosthesis eccentricity were measured before and after operation. Results Symptoms disappeared and no complication occurred after operation in the patients of 2 groups. The patients were followed up 12 to 18 months (mean, 15.3 months) in ACDF group and 6 to 12 months (mean, 9.6 months) in CADR group. The NDI scores in CADR group were significantly higher than those in ACDF group at 1, 3, and 6 months (P lt; 0.05), but no significant difference was observed in JOA score improvement rate between 2 groups (P gt; 0.05). According to Odom’s score at last follow-up, the results were excellent in 6 cases, good in 4 cases, and fair in 3 cases with an excellent and good rate of 76.92% in ACDF group, and were excellent in 9 cases, good in 1 case, and poor in 1 case with an excellent and good rate of 90.91% in CADR group, showing no significant difference (χ2=3.000, P=0.223). The patients in CADR group had significant limit of cervical joint ROM in flexion and extension and right bending at 1 month (P lt; 0.05), but cervical joint ROM restored after 3 months. The ROMs of left bending at 3 months and 6 months were bigger than preoperative value (P lt; 0.05). Meanwhile, ROM in left bending were bigger than that in right bending in replaced segment and upper segment (P lt; 0.05), and the ROM difference between left bending and right bending in upper segment was 2 times higher than that in the replaced segment; a marked linear correlation (P lt; 0.05) existed between the ROM difference and prosthesis eccentricity, and prosthesis bias had bigger ROM in lateral bending. Conclusion Discover cervical artificial disc replacement for treatment of cervical spondylosis can provide a good effectiveness and cervical postoperative movement function. As a new prosthesis, it has some merits such as simple operative steps and less complications.

Citation： QIAN Yufeng,XUE Feng,SHENG Xiaowen,LU Jianmin,CHEN Bingqian.. EARLY EFFECTIVENESS OF Discover CERVICAL ARTIFICIAL DISC REPLACEMENT IN TREATMENT OF CERVICAL SPONDYLOSIS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(3): 277-283. doi: Copy

1.	C artificial disc investigational device exemption study with a minimum 2-year follow-up. J Neurosurg Spine, 2011, 15(4): 348-358.
2.	Duggal N. Cervical disc arthroplasty: a practical overview. Curr Orthop Pract, 2009, 20(3): 216-221. 2 田伟, 刘波, 李勤. 人工椎间盘置换手术的临床初步应用体会. 中华医学杂志, 2005, 85(1): 37-40.
3.	Hukuda S, Mochizuki T, Ogata M, et al. Operations for cervical spondylotic myelopahty. A comparison of the results of anterior and posterior procedures. J Bone Jiont Surg (Br), 1985, 67(4): 609-615.
4.	伍少玲, 马超, 伍时玲. 颈椎功能障碍指数量表的效度与信度研究. 中国康复医学杂志, 2008, 23(7): 625-628.
5.	Greiner-Perth R, Allam Y, Silbermann J. First experience and preliminary clinical results with the cervical disc replacement discover. Z Orthop Unfall, 2009, 147(5): 582-587.
6.	White AA 3rd, Panjabi MM. The basic kinematics of the human spine. A review of past abd current knowledge. Spine (Phila Pa 1976), 1978, 3(1): 12-20.
7.	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. Spine (Phila Pa 1976), 2009, 34(2): 101-107.
8.	Coric D, Nunley PD, Guyer RD, et al. Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex.
9.	Park DK, Lin EL, Phillips FM. Index and adjacent level kinematics after cervical disc replacement and anterior fusion: in vivo quantitative radiographic analysis. Spine (Phila Pa 1976), 2011, 36(9): 721-730.
10.	Ahn PG, Kim KN, Moon SW, et al. Changes in cervical range of motion and sagittal alignment in early and late phases after total disc replacement: radiographic follow-up exceeding 2 years. J Neurosurg Spine, 2009, 11(6): 688-695.
11.	Cardoso MJ, Rosner MK. Multilevel cervical arthroplasty with artificial disc replacement. Neurosurg Focus, 2010, 28(5): E19.
12.	Anderson PA, Sasso RC, Riew KD. Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Spine (Phila Pa 1976), 2008, 33(12): 1305-1312.
13.	Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J, 2010, 10(8): 676-682.
14.	Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
15.	段丽群, 张文志, 尚希福, 等. Discover人工颈椎间盘置换在颈椎病治疗中的初期疗效观察. 颈腰痛杂志, 2011, 32(1): 9-13.
16.	Galbusera F, Anasetti F, Bellini CM. The influence of the axial, antero-posterior and lateral positions of the center of rotation of a ball-and-socket disc prosthesis on the cervical spine biomechanics. Clin Biomech (Bristol Avon), 2010, 25(5): 397-401.
17.	Chang UK, Kim DH, Lee MC, et al. Range of motion change after cervical arthroplasty with ProDisc-C and prestige artificial discs compared with anterior cervical discectomy and fusion. J Neurosurg Spine, 2007, 7(1): 40-46.
18.	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 Neurosurg Spine, 2007, 7(1): 33-39.19 Kang KC, Lee CS, Han JH, et al. The factors that influence the postoperative segmental range of motion after cervical artificial disc replacement. Spine J, 2010, 10(8): 689-696.
19.	Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J, 2004, 4 (6 Suppl): S190-194.
20.	Jawahar A, Cavanaugh DA, Kerr EJ 3rd, et al. Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J, 2010, 10(12): 1043-1048.
21.	Jiang H, Zhu Z, Qiu Y, et al. Cervical disc arthroplasty versus fusion for single-level symptomatic cervical disc disease: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg, 2012, 132(2): 141-145.
22.	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.

1. C artificial disc investigational device exemption study with a minimum 2-year follow-up. J Neurosurg Spine, 2011, 15(4): 348-358.
2. Duggal N. Cervical disc arthroplasty: a practical overview. Curr Orthop Pract, 2009, 20(3): 216-221. 2 田伟, 刘波, 李勤. 人工椎间盘置换手术的临床初步应用体会. 中华医学杂志, 2005, 85(1): 37-40.
3. Hukuda S, Mochizuki T, Ogata M, et al. Operations for cervical spondylotic myelopahty. A comparison of the results of anterior and posterior procedures. J Bone Jiont Surg (Br), 1985, 67(4): 609-615.
4. 伍少玲, 马超, 伍时玲. 颈椎功能障碍指数量表的效度与信度研究. 中国康复医学杂志, 2008, 23(7): 625-628.
5. Greiner-Perth R, Allam Y, Silbermann J. First experience and preliminary clinical results with the cervical disc replacement discover. Z Orthop Unfall, 2009, 147(5): 582-587.
6. White AA 3rd, Panjabi MM. The basic kinematics of the human spine. A review of past abd current knowledge. Spine (Phila Pa 1976), 1978, 3(1): 12-20.
7. 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. Spine (Phila Pa 1976), 2009, 34(2): 101-107.
8. Coric D, Nunley PD, Guyer RD, et al. Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex.
9. Park DK, Lin EL, Phillips FM. Index and adjacent level kinematics after cervical disc replacement and anterior fusion: in vivo quantitative radiographic analysis. Spine (Phila Pa 1976), 2011, 36(9): 721-730.
10. Ahn PG, Kim KN, Moon SW, et al. Changes in cervical range of motion and sagittal alignment in early and late phases after total disc replacement: radiographic follow-up exceeding 2 years. J Neurosurg Spine, 2009, 11(6): 688-695.
11. Cardoso MJ, Rosner MK. Multilevel cervical arthroplasty with artificial disc replacement. Neurosurg Focus, 2010, 28(5): E19.
12. Anderson PA, Sasso RC, Riew KD. Comparison of adverse events between the Bryan artificial cervical disc and anterior cervical arthrodesis. Spine (Phila Pa 1976), 2008, 33(12): 1305-1312.
13. Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J, 2010, 10(8): 676-682.
14. Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
15. 段丽群, 张文志, 尚希福, 等. Discover人工颈椎间盘置换在颈椎病治疗中的初期疗效观察. 颈腰痛杂志, 2011, 32(1): 9-13.
16. Galbusera F, Anasetti F, Bellini CM. The influence of the axial, antero-posterior and lateral positions of the center of rotation of a ball-and-socket disc prosthesis on the cervical spine biomechanics. Clin Biomech (Bristol Avon), 2010, 25(5): 397-401.
17. Chang UK, Kim DH, Lee MC, et al. Range of motion change after cervical arthroplasty with ProDisc-C and prestige artificial discs compared with anterior cervical discectomy and fusion. J Neurosurg Spine, 2007, 7(1): 40-46.
18. 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 Neurosurg Spine, 2007, 7(1): 33-39.19 Kang KC, Lee CS, Han JH, et al. The factors that influence the postoperative segmental range of motion after cervical artificial disc replacement. Spine J, 2010, 10(8): 689-696.
19. Hilibrand AS, Robbins M. Adjacent segment degeneration and adjacent segment disease: the consequences of spinal fusion? Spine J, 2004, 4 (6 Suppl): S190-194.
20. Jawahar A, Cavanaugh DA, Kerr EJ 3rd, et al. Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials. Spine J, 2010, 10(12): 1043-1048.
21. Jiang H, Zhu Z, Qiu Y, et al. Cervical disc arthroplasty versus fusion for single-level symptomatic cervical disc disease: a meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg, 2012, 132(2): 141-145.
22. 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.

Chinese Journal of Reparative and Reconstructive Surgery

EARLY EFFECTIVENESS OF Discover CERVICAL ARTIFICIAL DISC REPLACEMENT IN TREATMENT OF CERVICAL SPONDYLOSIS

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