DOI QR코드

DOI QR Code

Comparative Analysis of Cervical Arthroplasty Using Mobi-$C^{(R)}$ and Anterior Cervical Discectomy and Husion Using the $Solis^{(R)}$-Cage

  • Park, Jin-Hoon (Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Roh, Kwang-Ho (Junior Grade of Williston Northampton School) ;
  • Cho, Ji-Young (Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Ra, Young-Shin (Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Rhim, Seung-Chul (Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Noh, Sung-Woo (Department of Neurosurgery, Asan Medical Center, College of Medicine, University of Ulsan)
  • Published : 2008.10.28

Abstract

Objective : Although anterior cervical discectomy and fusion (ACDF) is the standard treatment for degenerative cervical disc disease, concerns regarding adjacent level degeneration and loss of motion have suggested that arthroplasty may be a better alternative. We have compared clinical and radiological results in patients with cervical disc herniations treated with arthroplasty and ACDF. Methods : We evaluated 53 patients treated for cervical disc herniations with radiculopathy, 21 of whom underwent arthroplasty and 32 of whom underwent ACDF. Clinical results included the Visual Analogue Scale (VAS) score for upper extremity radiculopathy, neck disability index (NDI), duration of hospital stay and convalescence time. All patients were assessed radiologically by measuring cervical lordosis, segmental lordosis and segmental range-of-movement (ROM) of operated and adjacent disc levels. Results : Mean hospital stay (5.62 vs. 6.26 days, p<0.05) and interval between surgery and return to work (1.10 vs 2.92 weeks, p<0.05) were significantly shorter in the arthroplasty than in the fusion group. Mean NDI and extremity VAS score improved after 12 months in both groups. Although it was not significant, segmental ROM of adjacent levels was higher in the fusion group than in the arthroplasty group. And, segmental motion of operated levels in arthroplasty group maintained more than preoperative value at last follow up. Conclusion : Although clinical results were similar in the two groups, postoperative recovery was significantly shorter in the arthroplasty group. Although it was not significant, ROM of adjacent segments was less in the arthroplasty group. Motion of operated levels in arthroplasty group was preserved at last follow up.

Keywords

References

  1. Cummins BH, Robertson JT, Gill SS : Surgical experience with an implanted artificial cervical joint. J Neurosurg 88 : 943-948, 1998 https://doi.org/10.3171/jns.1998.88.6.0943
  2. Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, et al : Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine 27 : 2431-2434, 2002 https://doi.org/10.1097/00007632-200211150-00003
  3. Goffin J, Geusens E, Vantomme N, Quintens E, Waerzeggers Y, Depreitere B, et al : Long-term follow-up after interbody fusion of the cervical spine. J Spinal Disord Tech 17 : 79-85, 2004 https://doi.org/10.1097/00024720-200404000-00001
  4. Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH : Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81 : 519-528, 1999 https://doi.org/10.2106/00004623-199904000-00009
  5. Katsuura A, Hukuda S, Saruhashi Y, Mori K : Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels. Eur Spine J 10 : 320-324, 2001 https://doi.org/10.1007/s005860000243
  6. Kim SH, Shin HC, Shin DA, Kim KN, Yoon do H : Early clinical experience with the mobi-C disc prosthesis. Yonsei Med J 48 : 457-464, 2007 https://doi.org/10.3349/ymj.2007.48.3.457
  7. Kim SW, Shin JH, Arbatin JJ, Park MS, Chung YK, McAfee PC : Effects of a cervical disc prosthesis on maintaining sagittal alignment of the functional spinal unit and overall sagittal balance of the cervical spine. Eur Spine J 17 : 20-29, 2008 https://doi.org/10.1007/s00586-007-0459-y
  8. Kulkarni V, Rajshekhar V, Raghuram L : Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy : magnetic resonance imaging study evidence. J Neurosurg 100 : 2-6, 2004 https://doi.org/10.3171/jns.2004.100.1.0002
  9. Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA : Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion : a randomized controlled clinical trial. J Neurosurg Spine 6 : 198-209, 2007 https://doi.org/10.3171/spi.2007.6.3.198
  10. Nabhan A, Ahlhelm F, Pitzen T, Steudel WI, Jung J, Shariat K, et al : Disc replacement using Pro-Disc C versus fusion : a prospective randomised and controlled radiographic and clinical study. Eur Spine J 16 : 423-430, 2007 https://doi.org/10.1007/s00586-006-0226-5
  11. Pickett GE, Rouleau JP, Duggal N : Kinematic analysis of the cervical spine following implantation of an artificial cervical disc. Spine 30 : 1949-1954, 2005 https://doi.org/10.1097/01.brs.0000176320.82079.ce
  12. Sasso RC, Smucker JD, Hacker RJ, Heller JG : Artificial disc versus fusion : a prospective, randomized study with 2-year follow-up on 99 patients. Spine 32 : 2933-2940, 2007 https://doi.org/10.1097/BRS.0b013e31815d0034
  13. Shim CS, Lee SH, Park HJ, Kang HS, Hwang JH : Early clinical and radiologic outcomes of cervical arthroplasty with Bryan Cervical Disc prosthesis. J Spinal Disord Tech 19 : 465-470, 2006 https://doi.org/10.1097/01.bsd.0000211235.76093.6b
  14. Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, et al : Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine 28 : 134-139, 2003 https://doi.org/10.1097/00007632-200301150-00008
  15. St John TA, Vaccaro AR, Sah AP, Schaefer M, Berta SC, Albert T, et al : Physical and monetary costs associated with autogenous bone graft harvesting. Am J Orthop 32 : 18-23, 2003
  16. van Jonbergen HP, Spruit M, Anderson PG, Pavlov PW : Anterior cervical interbody fusion with a titanium box cage : early radiological assessment of fusion and subsidence. Spine J 5 : 645-649, 2005 https://doi.org/10.1016/j.spinee.2005.07.007
  17. Weinhoffer SL, Guyer RD, Herbert M, Griffith SL : Intradiscal pressure measurements above an instrumented fusion. A cadaveric study. Spine 20 : 526-531, 1995 https://doi.org/10.1097/00007632-199503010-00004
  18. Yoon DH, Yi S, Shin HC, Kim KN, Kim SH : Clinical and radiological results following cervical arthroplasty. Acta Neurochir (Wien) 148 : 943-950, 2006 https://doi.org/10.1007/s00701-006-0805-6

Cited by

  1. Intermediate clinical and radiological results of cervical TDR (Mobi-C®) with up to 2 years of follow-up vol.18, pp.6, 2008, https://doi.org/10.1007/s00586-009-1017-6
  2. Surgical Outcome of Cervical Arthroplasty Using $Bryan^{(R)}$ vol.46, pp.6, 2009, https://doi.org/10.3340/jkns.2009.46.6.532
  3. Comparative Study Between Cervical Disc Prosthesis and Anterior Cervical Discectomy With Fusion vol.20, pp.3, 2010, https://doi.org/10.1097/wnq.0b013e3181ebceca
  4. Cervical Radiculopathy due to Cervical Degenerative Diseases : Anatomy, Diagnosis and Treatment vol.48, pp.6, 2008, https://doi.org/10.3340/jkns.2010.48.6.473
  5. Advantages of the Plating for Anterior Cervical Discectomy and fusion: Comparison with Wearing Cervical Collar Without Plate vol.8, pp.3, 2008, https://doi.org/10.14245/kjs.2011.8.3.161
  6. Remodeling of adjacent spinal alignments following cervical arthroplasty and anterior discectomy and fusion vol.21, pp.2, 2008, https://doi.org/10.1007/s00586-011-2000-6
  7. Past, Present, and Future of Cervical Arthroplasty vol.62, pp.2, 2008, https://doi.org/10.2302/kjm.2012-0014-re
  8. Arthroplasty Versus Fusion in Single-Level Cervical Degenerative Disc Disease: A Cochrane Review vol.38, pp.17, 2008, https://doi.org/10.1097/brs.0b013e3182994a32
  9. Fusion-Nonfusion Hybrid Construct Versus Anterior Cervical Hybrid Decompression and Fusion : A Comparative Study for 3-Level Cervical Degenerative Disc Diseases vol.39, pp.23, 2014, https://doi.org/10.1097/brs.0000000000000588
  10. X-Ray-based Kinematic Analysis of Cervical Spine According to Prosthesis Designs: Analysis of the Mobi C, Bryan, PCM, and Prestige LP vol.28, pp.5, 2008, https://doi.org/10.1097/bsd.0b013e318288a923
  11. Effectiveness and safety of Mobi-C for treatment of single-level cervical disc spondylosis : a randomised control trial with a minimum of five years of follow-up vol.98, pp.6, 2008, https://doi.org/10.1302/0301-620x.98b6.36381
  12. Segmental Motion of the Cervical Spine After Total Disc Replacement Using ActivC Versus Discectomy and Fusion Using Stand-alone Cage vol.126, pp.None, 2008, https://doi.org/10.1016/j.wneu.2019.02.233
  13. Cervical radiculopathy: is a prosthesis preferred over fusion surgery? A systematic review vol.29, pp.11, 2008, https://doi.org/10.1007/s00586-019-06175-y
  14. Preliminary Clinical Outcome of One-level Mobi-C Total Disc Replacement in Japanese Population vol.5, pp.6, 2008, https://doi.org/10.22603/ssrr.2021-0015
  15. Cervical Total Disc Replacement and Heterotopic Ossification: A Review of Literature Outcomes and Biomechanics vol.15, pp.1, 2021, https://doi.org/10.31616/asj.2019.0234
  16. Deep Learning for Adjacent Segment Disease at Preoperative MRI for Cervical Radiculopathy vol.301, pp.3, 2008, https://doi.org/10.1148/radiol.2021204731
  17. The Clinical Relevance of the Cervical Disc Prosthesis : Combining Clinical Results of Two RCTs vol.47, pp.1, 2022, https://doi.org/10.1097/brs.0000000000004113