Skip to main content

Advertisement

SpringerLink
Log in

Cervical arthroplasty with Discover prosthesis: clinical outcomes and analysis of factors that may influence postoperative range of motion

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

The aim of this current study was to analyze the clinical outcomes after Discover cervical disc replacement and its effects on maintaining cervical lordosis and range of motion (ROM). The possible factors influencing postoperative ROM were analyzed.

Method

27 men and 28 women with a mean age of 46.4 ± 8.7 years were prospectively followed up for 2 years. Clinical outcomes were assessed using Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), visual analog scale (VAS) and Odom’s criteria. Radiographic information including segment and overall alignment, functional spinal unit (FSU) and overall ROM, and disc heights were prospectively collected during the follow-up. The correlations between the postoperative FSU ROM at last follow-up and influencing factors were analyzed.

Results

Mean NDI, JOA and VAS scores showed statistical improvements at last follow-up. Anterior migration of the prosthesis was detected in six cases. Heterotopic ossification was observed in ten patients. Mean FSU angle, endplate angle of the treated level and mean overall cervical alignment were all improved significantly at last follow-up (P < 0.001). However, mean FSU ROM of the treated segment significantly decreased postoperatively (P = 0.008), while mean overall ROM showed no significant differences. A significant correlation was found between preoperative FSU ROM and postoperative FSU ROM by the Pearson correlation coefficient (r = 0.325, P = 0.034). Multiple linear regression analysis confirmed that preoperative FSU ROM contributed independently to a model with a coefficient of determination of 0.37 (P = 0.034).

Conclusions

In the 2 years follow-up, the Discover cervical disc arthroplasty has provided satisfactory clinical outcomes. It was able to substantially restore segment and overall cervical alignment while partially maintaining segment and overall cervical ROM. Additionally, we found that postoperative FSU ROM positively correlated with preoperative FSU ROM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chang UK, Kim DH, Lee MC, Willenberg R, Kim SH, Lim J (2007) Range of motion change after cervical arthroplasty with ProDisc-C and prestige artificial discs compared with anterior cervical discectomy and fusion. J Neurosurg Spine 7(1):40–46. doi:10.3171/spi-07/07/040

    Article  PubMed  Google Scholar 

  2. Rabin D, Bertagnoli R, Wharton N, Pickett GE, Duggal N (2009) Sagittal balance influences range of motion: an in vivo study with the ProDisc-C. Spine J: Off J N Am Spine Soc 9(2):128–133. doi:10.1016/j.spinee.2008.01.009

    Article  Google Scholar 

  3. Kang KC, Lee CS, Han JH, Chung SS (2010) The factors that influence the postoperative segmental range of motion after cervical artificial disc replacement. Spine J: Off J North Am Spine Soc 10(8):689–696. doi:10.1016/j.spinee.2010.04.016

    Article  Google Scholar 

  4. Du J, Li M, Liu H, Meng H, He Q, Luo Z (2011) Early follow-up outcomes after treatment of degenerative disc disease with the Discover cervical disc prosthesis. Spine J: Off J North Am Spine Soc 11(4):281–289. doi:10.1016/j.spinee.2011.01.037

    Article  Google Scholar 

  5. Pickett GE, Mitsis DK, Sekhon LH, Sears WR, Duggal N (2004) Effects of a cervical disc prosthesis on segmental and cervical spine alignment. Neurosurg Focus 17(3):E5

    Article  PubMed  Google Scholar 

  6. Sasso RC, Smucker JD, Hacker RJ, Heller JG (2007) Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine 32(26):2933–2940. doi:10.1097/BRS.0b013e31815d0034 (discussion 2941–2932)

    Article  PubMed  Google Scholar 

  7. Sasso RC, Best NM, Metcalf NH, Anderson PA (2008) Motion analysis of Bryan cervical disc arthroplasty versus anterior discectomy and fusion: results from a prospective, randomized, multicenter, clinical trial. J Spinal Disord Tech 21(6):393–399. doi:10.1097/BSD.0b013e318150d121

    Article  PubMed  Google Scholar 

  8. Nabhan A, Ahlhelm F, Shariat K, Pitzen T, Steimer O, Steudel WI, Pape D (2007) The ProDisc-C prosthesis: clinical and radiological experience 1 year after surgery. Spine 32(18):1935–1941. doi:10.1097/BRS.0b013e31813162d8

    Article  PubMed  Google Scholar 

  9. Park DK, Lin EL, Phillips FM (2011) Index and adjacent level kinematics after cervical disc replacement and anterior fusion: in vivo quantitative radiographic analysis. Spine 36(9):721–730. doi:10.1097/BRS.0b013e3181df10fc

    Article  PubMed  Google Scholar 

  10. Nabhan A, Ahlhelm F, Pitzen T, Steudel WI, Jung J, Shariat K, Steimer O, Bachelier F, Pape D (2007) Disc replacement using Pro-Disc C versus fusion: a prospective randomised and controlled radiographic and clinical study. Eur Spine J: Off Pub Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 16(3):423–430. doi:10.1007/s00586-006-0226-5

    CAS  Google Scholar 

  11. Anakwenze OA, Auerbach JD, Milby AH, Lonner BS, Balderston RA (2009) Sagittal cervical alignment after cervical disc arthroplasty and anterior cervical discectomy and fusion: results of a prospective, randomized, controlled trial. Spine 34(19):2001–2007. doi:10.1097/BRS.0b013e3181b03fe6

    Article  PubMed  Google Scholar 

  12. Ahn PG, Kim KN, Moon SW, Kim KS (2009) 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 11(6):688–695. doi:10.3171/2009.7.spine0946

    Article  PubMed  Google Scholar 

  13. Barrey C, Champain S, Campana S, Ramadan A, Perrin G, Skalli W (2012) Sagittal alignment and kinematics at instrumented and adjacent levels after total disc replacement in the cervical spine. Eur Spine J: Off Pub Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 21(8):1648–1659. doi:10.1007/s00586-012-2180-8

    Google Scholar 

  14. Guerin P, Obeid I, Gille O, Bourghli A, Luc S, Pointillart V, Vital JM (2012) Sagittal alignment after single cervical disc arthroplasty. J Spinal Disord Tech 25(1):10–16. doi:10.1097/BSD.0b013e31820f916c

    Article  PubMed  Google Scholar 

  15. Fong SY, DuPlessis SJ, Casha S, Hurlbert RJ (2006) Design limitations of Bryan disc arthroplasty. Spine J: Off J N Am Spine Soc 6(3):233–241. doi:10.1016/j.spinee.2006.01.007

    Article  Google Scholar 

  16. Johnson JP, Lauryssen C, Cambron HO, Pashman R, Regan JJ, Anand N, Bray R (2004) Sagittal alignment and the Bryan cervical artificial disc. Neurosurg Focus 17(6):E14

    Article  PubMed  Google Scholar 

  17. McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech 16(4):384–389

    Article  PubMed  Google Scholar 

  18. Garrido BJ, Taha TA, Sasso RC (2010) Clinical outcomes of Bryan cervical disc arthroplasty a prospective, randomized, controlled, single site trial with 48-month follow-up. J Spinal Disord Tech 23(6):367–371. doi:10.1097/BSD.0b013e3181bb8568

    Article  PubMed  Google Scholar 

  19. Goffin J, Van Calenbergh F, van Loon J, Casey A, Kehr P, Liebig K, Lind B, Logroscino C, Sgrambiglia R, Pointillart V (2003) Intermediate follow-up after treatment of degenerative disc disease with the Bryan cervical disc prosthesis: single-level and bi-level. Spine 28(24):2673–2678. doi:10.1097/01.brs.0000099392.90849.aa

    Article  PubMed  Google Scholar 

  20. Heidecke V, Burkert W, Brucke M, Rainov NG (2008) Intervertebral disc replacement for cervical degenerative disease—clinical results and functional outcome at two years in patients implanted with the Bryan cervical disc prosthesis. Acta Neurochir 150(5):453–459. doi:10.1007/s00701-008-1552-7 (discussion 459)

    Article  PubMed  CAS  Google Scholar 

  21. Beaurain J, Bernard P, Dufour T, Fuentes JM, Hovorka I, Huppert J, Steib JP, Vital JM, Aubourg L, Vila T (2009) Intermediate clinical and radiological results of cervical TDR (Mobi-C) with up to 2 years of follow-up. Eur Spine J: Off Pub Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 18(6):841–850. doi:10.1007/s00586-009-1017-6

    CAS  Google Scholar 

  22. Suchomel P, Jurak L, Benes V 3rd, Brabec R, Bradac O, Elgawhary S (2010) Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Eur Spine J: Off Pub Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 19(2):307–315. doi:10.1007/s00586-009-1259-3

    Google Scholar 

  23. Peng CW, Quirno M, Bendo JA, Spivak JM, Goldstein JA (2009) Effect of intervertebral disc height on postoperative motion and clinical outcomes after Prodisc-C cervical disc replacement. Spine J: Off J N Am Spine Soc 9(7):551–555. doi:10.1016/j.spinee.2009.03.008

    Article  Google Scholar 

  24. Tian W, Han X, Liu B, Li Q, Hu L, Li ZY, Yuan Q, He D, Xing YG (2010) Clinical and radiographic results of cervical artificial disc arthroplasty: over three years follow-up cohort study. Chin Med J 123(21):2969–2973

    PubMed  Google Scholar 

  25. Kim SW, Paik SH, Castro PA, Baek SW, Shin DJ, Kwak YH, Ju YS (2010) Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J: Off J N Am Spine Soc 10(8):683–688. doi:10.1016/j.spinee.2010.04.027

    Article  Google Scholar 

Download references

Conflict of interest

None of the authors has any potential conflict of interest. No funds were received in support of this work.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Changzheng Hospital of the Second Military Medical University, Shanghai, 200003, China

    Jun Li, Lei Liang, Min Qi, Hua-jiang Chen & Wen Yuan

  2. Department of Health Statistics, The Second Military Medical University, Shanghai, China

    Xiao-fei Ye

Authors
  1. Jun Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lei Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xiao-fei Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Min Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hua-jiang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wen Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wen Yuan.

Additional information

J. Li and L. Liang contributed equally to this paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, J., Liang, L., Ye, Xf. et al. Cervical arthroplasty with Discover prosthesis: clinical outcomes and analysis of factors that may influence postoperative range of motion. Eur Spine J 22, 2303–2309 (2013). https://doi.org/10.1007/s00586-013-2897-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-013-2897-z

Keywords

Search

Navigation