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Risk Factors For Cervical Disc Arthroplasty Subsidence With Bryan Disc-A Retrospective Observational Analysis – Cervical Disc Replacement

The article discusses the use of cervical disc arthroplasty (CDA) as an alternative to fusion in preserving cervical spine motion, with a focus on the potential complication of implant subsidence. The study included 104 patients who underwent 153 CDA levels with the Bryan Disc, and approximately 22.9% of the implants showed subsidence. The analysis identified pre-operative mean disc height as an independent risk factor for subsidence, with a cut-off value of 4.48 mm for pre-OP Mean-DH in the risk for implant subsidence. The study also found that implant subsidence incidence was higher than previously reported, possibly due to endplate over-preparation or disc space over-distraction during placement

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established spine centre in London

Published article

Background: Cervical disc arthroplasty (CDA) is currently used instead of fusion to preserve cervical spine motion. Cervical implant subsidence is a potential complication after CDA. Methods: Radiological measurements were recorded via patient anteroposterior and lateral radiographs in the neutral position. Subsidence was defined as a decrease of 3 mm or more in functional spinal unit height (FSUH) from which was measured on a post-operative (OP) radiograph. Results: This study included 104…

Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Cervical disc arthroplasty (CDA) is currently used instead of fusion to preserve cervical spine motion. Cervical implant subsidence is a potential complication after CDA. Methods: Radiological measurements were recorded via patient anteroposterior and lateral radiographs in the neutral position. Subsidence was defined as a decrease of 3 mm or more in functional spinal,

Abstract

Background: Cervical disc arthroplasty (CDA) is currently used instead of fusion to preserve cervical spine motion. Cervical implant subsidence is a potential complication after CDA. Methods: Radiological measurements were recorded via patient anteroposterior and lateral radiographs in the neutral position. Subsidence was defined as a decrease of 3 mm or more in functional spinal unit height (FSUH) from which was measured on a post-operative (OP) radiograph. Results: This study included 104 patients who underwent 153 CDA levels with the Bryan Disc. Approximately one-quarter of the implants (22.9%) showed subsidence. Binary logistic regression analysis indicated that pre-OP mean disc height (DH) was identified as an independent risk factor for subsidence in multivariate analysis (0.151, 95% Confidence Interval 0-0.073, p = 0.018). Receiver operating characteristic curve analysis (area under the curve = 0.852, sensitivity 84.7%, specificity 77.1%) revealed a cut-off value of 4.48 mm for pre-OP Mean-DH in the risk for implant subsidence. Conclusions: In this study, the subsidence rate significantly increased when the implants were oversized beyond a pre-OP Mean-DH of approximately >4 mm. Moreover, the implant subsidence incidence was higher than that reported in previous studies. This is possibly due to endplate over-preparation or disc space over-distraction during placement at the same height as the Bryan Disc (8.5 mm).

Keywords: Bryan disc; cervical disc arthroplasty; functional spinal unit height; implant height; implant subsidence; mean disc height; oversized.

The London Spine Unit : most established spine centre in London

Read the original publication:

Risk Factors for Cervical Disc Arthroplasty Subsidence with Bryan Disc-A Retrospective Observational Analysis

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Abstract Background: Cervical disc arthroplasty (CDA) is currently used instead of fusion to preserve cervical spine motion. Cervical implant subsidence is a potential complication after CDA. Methods: Radiological measurements were recorded via patient anteroposterior and lateral radiographs in the neutral position. Subsidence was defined as a decrease of 3 mm or more in functional spinal

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