Scientific and radiographic end result of dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc illness: a minimal five-year follow-up.
BMC Musculoskelet Disord. 2018 Apr 04;19(1):101
Authors: Wang LN, Hu BW, Wang L, Music YM, Yang X, Liu LM, Liu H
BACKGROUND: To guage the mid- to long-term scientific and radiographic outcomes of anterior cervical discectomy and dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc illness.
METHODS: From April 2010 to October 2010, 38 sufferers with single- or double-level cervical disc herniation underwent anterior cervical discectomy and DCI arthroplasty. The scientific outcomes and radiographic outcomes of those 38 sufferers (42 ranges) have been retrospectively evaluated. The scientific outcomes included the visible analogue scale, Japanese Orthopaedic Affiliation rating, Neck Incapacity Index rating, 36-item brief kind well being survey questionnaire, and incidences of problems and neurological deterioration. Radiographic outcomes together with cervical alignment, intervertebral peak, cervical vary of movement (ROM), ROM of the practical spinal unit, adjoining intervertebral ROM, migration, subsidence, and heterotopic ossification (HO) have been assessed on plain radiography, three-dimensional computed tomography, and magnetic resonance imaging.
RESULTS: The imply follow-up interval was 72.three months (vary 68-78 months). Throughout follow-up, all sufferers confirmed vital enhancements within the visible analogue scale rating, Japanese Orthopaedic Affiliation rating, Neck Incapacity Index rating, 36-item brief kind well being survey bodily element abstract rating and psychological element abstract rating. The ROM of the practical spinal unit was partly lowered. The DCI migrated ahead in 10 of 42 (23.eight%) instances, and HO was detected in 24 of the 42 (57.1%) DCI segments. Subsidence was noticed in 14 of 42 (33.three%) DCI segments. Two sufferers skilled symptom recurrence, and have been handled conservatively.
CONCLUSIONS: The scientific efficacy of DCI arthroplasty was maintained throughout mid- to long-term follow-up. HO formation is a standard phenomenon, resulting in a considerable lower in ROM on the index stage and recurrence of neurological signs. The incidence of implant subsidence and migration is comparatively excessive, leaving a possible danger of signs on the index stage and adjoining section degeneration. We contemplate that the primary alternative for sufferers with degenerative cervical disc illness ought to nonetheless be whole disc alternative or anterior cervical discectomy and fusion, reasonably than DCI arthroplasty.
PMID: 29615017 [PubMed – in process]