nach oben

Erschienen in:

01.05.2014 | Original Article

Does sagittal position of the CTDR-related centre of rotation influence functional outcome? Prospective 2-year follow-up analysis

verfasst von: P. Suchomel, L. Jurák, J. Antinheimo, J. Pohjola, J. Stulik, H.-J. Meisel, M. Čabraja, C. Woiciechowsky, B. Bruchmann, I. Shackleford, R. Arregui, S. Sola

Erschienen in: European Spine Journal | Ausgabe 5/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Recent studies describe significant rates of heterotopic ossification (HO) after cervical total disc replacement (CTDR). Little is known about the reasons, and one aspect that requires further in vivo investigation is the biomechanical alteration after CTDR and the role of the implant-related centre of rotation (CORi) in particular. The role of the sagittal position of the CORi on functional outcome in two versions of a semi-constrained disc prosthesis with sagittally different CORi is the topic of this study.

Methods

Patients were candidates for single-level CTDR between C3 and C7 who suffered from CDDD and received a standard or flat version of activ C™ (Aesculap AG, Tuttlingen). Clinical and radiographic assessments were determined preoperatively, intraoperatively, at discharge and again at 6 weeks, 6 months, 1 and 2 years. Radiographic examinations were performed independently using specialized quantitative motion analysis software.

Results

Clinical outcome improved significantly regarding NDI as well as VAS on neck and arm pain with no differences in mean improvement by study group. Segmental angle measures show a significantly better lordotic alignment for both groups after surgery, but the degree of correction achieved is higher in the flat group. Correlation analysis proves that the more anterior the CORi is positioned, the higher the lordotic correction is achieved (Pearson rho −0.385). Segmental ROM decreased in the standard group but was maintained for flat implants. At present, our data do not demonstrate a correlation between CORi and ROM at 2 years. Two years after surgery, severe HO grade III–IV was present in 31.6 % standard and 13.1 % flat cases with significant differences. Grouping according to HO severity showed comparable sagittal positions of CORi for flat implants but a more posterior position in the severe HO group for standard implants.

Conclusions

Our results confirm the influence of CORi location on segmental alignment, kinematics and HO for a semi-constrained CTDR, but it also indicates a multifactorial process.

Cloward RB (1952) The treatment of ruptured intervertebral disc by vertebral body fusion. III. Method of use of banked bone. Ann Surg 136:987–992PubMedCentralPubMedCrossRef

Hilibrand AS, Yoo JU, Carlson GD, Bohlman HH (1997) The success of anterior cervical arthrodesis adjacent to a previous fusion. Spine 15(22):1574–1579CrossRef

Smith GW, Robinson RA (1958) The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am 40:607–624PubMed

Bohlman HH, Emery SE, Goodfellow DB, Jones PK (1993) Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am 75(9):1298–1307PubMed

Baba H, Furusawa N, Imura S, Kawahara N, Tsuchiya H, Tomita K (1993) Late radiographic findings after anterior cervical fusion for spondylotic myeloradiculopathy. Spine 18(15):2167–2173PubMedCrossRef

McGrory BJ, Klassen RA (1994) Arthrodesis of the cervical spine for fractures and dislocations in children and adolescents. A long-term follow-up study. J Bone Joint Surg Am 76(11):1606–1616PubMed

Gore DR, Sepic SB (1998) Anterior discectomy and fusion for painful cervical disc disease. A report of 50 patients with an average follow-up of 21 years. Spine 23(19):2047–2051PubMedCrossRef

Katsuura A, Hukuda S, Saruhashi Y, Mori K (2001) Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent intervertebral levels. Eur Spine J 10(4):320–324PubMedCentralPubMedCrossRef

Goffin J, van Loon J, Van Calenbergh F, Plets C (1995) Long-term results after anterior cervical fusion and osteosynthetic stabilization for fractures and/or dislocations of the cervical spine. J Spinal Disord 8:500–508PubMedCrossRef

10.

Kulkarni V, Rajshekhar V, Raghuram L (2004) Accelerated spondylotic changes adjacent to the fused segment following central cervical corpectomy: magnetic resonance imaging study evidence. J Neurosurg 100(1 Suppl Spine):2–6PubMed

11.

Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH (1999) Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 81:519–528PubMed

12.

Pospiech J, Stolke D, Wilke HJ, Claes LE (1999) Intradiscal pressure recordings in the cervical spine. Neurosurgery 44(2):379–384 (discussion 384–385)PubMedCrossRef

13.

Eck JC, Humphreys SC, Lim TH, Jeong ST, Kim JG, Hodges SD, An HS (2002) Biomechanical study on the effect of cervical spine fusion on adjacent-level intradiscal pressure and segmental motion. Spine 15(27):2431–2434CrossRef

14.

DiAngelo DJ, Roberston JT, Metcalf NH, McVay BJ, Davis RC (2003) Biomechanical testing of an artificial cervical joint and an anterior cervical plate. J Spinal Disord Tech 16:314–323PubMedCrossRef

15.

Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC (2005) Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty. Spine 30:1165–1172PubMedCrossRef

16.

Robertson JT, Papadopoulos SM, Traynelis VC (2005) Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study. J Neurosurg Spine 3:417–423PubMedCrossRef

17.

Heller JG, Sasso RC, Papadopoulos SM, Anderson PA, Fessler RG, Hacker RJ, Coric D, Cauthen JC, Riew DK (2009) Comparison of BRYAN cervical disc arthroplasty with anterior cervical decompression and fusion: clinical and radiographic results of a randomized, controlled, clinical trial. Spine 34(2):101–107PubMedCrossRef

18.

McAfee PC, Reah C, Gilder K et al (2012) A meta-analysis of comparative outcomes following cervical arthroplasty or anterior cervical fusion: results from four prospective multi-center randomized clinical trials and up to 1226 patients. Spine 37:943–952PubMedCrossRef

19.

Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay B, Darden B (2009) Results of the prospective, randomized, controlled multicentre Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 9:275–286PubMedCrossRef

20.

Sasso RC, Anderson PA, Riew KD, Heller JG (2011) Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. J Bone Joint Surg Am 93:1684–1692PubMedCrossRef

21.

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 28:2673–2678PubMedCrossRef

22.

Pimenta L, McAfee PC, Cappuccino A, Bellera FP, Link HD (2004) Clinical experience with the new artificial cervical PCM (Cervitech) disc. Spine J 4:315S–321SPubMedCrossRef

23.

Leung C, Casey AT, Goffin J, Kehr P, Liebig K, Lind B, Logroscino C, Pointillart V (2005) Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery 57:759–763 (discussion 759–763)PubMedCrossRef

24.

Mehren C, Suchomel P, Grochulla F, Barsa P, Sourkova P, Hradil J, Korge A, Mayer HM (2006) Heterotopic ossification in total cervical artificial disc replacement. Spine 31(24):2802–2806PubMedCrossRef

25.

Sola S, Hebecker R, Mann S (2008) Bryan cervical disc prosthesis: 5 years follow-up. In: Motion preservation technology 8th annual meeting. Miami, Florida, May 6–9 2008

26.

Bartels RH, Donk R, Verbeek AL (2010) No justification for cervical disk prostheses in clinical practice: a meta-analysis of randomized controlled trials. Neurosurgery 66:1153–1160 (discussion 1160)PubMedCrossRef

27.

Zechmeister I, Winkler R, Mad P (2011) Artificial total disc replacement versus fusion for the cervical spine: a systematic review. Eur Spine J 20:177–184PubMedCentralPubMedCrossRef

28.

Galbusera F, Bellini CM, Brayda-Bruno M, Fornari M (2008) Biomechanical studies on cervical total disc arthroplasty: a literature review. Clin Biomech 23(9):1095–1104CrossRef

29.

Sears WR, McCombe PF, Sasso RC (2006) Kinematics of cervical and lumbar total disc replacement. Semin Spine Surgery 18:117–129CrossRef

30.

Koller H, Meier O, Zenner J, Mayer M, Hitzl W (2013) In vivo analysis of cervical kinematics after implantation of a minimally constrained cervical artificial disc replacement. Eur Spine J 22:747–758PubMedCentralPubMedCrossRef

31.

Ghiselli G, Wharton N, Hipp J, Wong D, Jatana S (2011) Prospective analysis of imaging prediction of pseudarthrosis after anterior cervical discectomy and fusion: computed tomography vs. flexion-extension motion analysis with intraoperative correlation. Spine 36(6):463–468PubMedCrossRef

32.

Reitman CA, Hipp JA, Nguyen L, Esses SI (2004) Changes in segmental intervertebral motion adjacent to cervical arthrodesis. A prospective study. Spine 29:E211–E226CrossRef

33.

Sears WR, Duggal N, Sekhon LH, Williamson OD (2007) Segmental malalignment with the Bryan cervical disc prosthesis-contributing factors. J Spinal Disord Tech 20:111–117PubMedCrossRef

34.

Taylor M, Hipp JA, Gertzbein SD, Reitman CA, Gopinath S (2007) Observer agreement in assessing flexion-extension X-rays of the cervical spine, with and without the use of quantitative measurements of intervertebral motion. Spine J 7:654–658PubMedCentralPubMedCrossRef

35.

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

36.

Dvorak J, Panjabi MM, Novotny JE, Antinnes JA (1991) In vivo flexion/extension of the normal cervical spine. J Orthop Res 9:828–834PubMedCrossRef

37.

Lee CK, Goel VK (2004) Artificial disc prosthesis: design concepts and criteria. Spine J 4:209–218CrossRef

38.

Jorritsma W, Dijkstra PU, de Vries GE, Geertzen JH, Reneman MF (2012) Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index. Eur Spine J 12:2550–2557CrossRef

39.

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 18(6):841–850PubMedCentralPubMedCrossRef

40.

Robertson JT, Metcalf NH (2004) Long-term outcome after implantation of the Prestige I disc in an end-stage indication: 4-year results from a pilot study. Neurosurg Focus 17(3):E10CrossRef

41.

Suchomel P, Jurák L, Benes V 3rd, Brabec R, Bradác 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 19(2):307–315PubMedCentralPubMedCrossRef

42.

Upadhyaya CD, Wu JC, Trost G, Haid RW, Traynelis VC, Tay B, Coric D, Mummaneni PV (2012) Analysis of the three United States Food and Drug Administration investigational device exemption cervical arthroplasty trials. J Neurosurg Spine 16:216–228PubMedCrossRef

43.

Yoon DH, Yi S, Shin C, Kim KN, Kim SH (2006) Clinical and radiological results following cervical arthroplasty. Acta Neurochir 148:943–950PubMedCrossRef

44.

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 9(2):128–133PubMedCrossRef

45.

Rousseau MA, Cottin P, Levante S, Nogier A, Lazennec JY, Skalli W (2008) In vivo kinematics of two types of ball-and-socket cervical disc replacements in the sagittal plane: cranial versus caudal geometric centre. Spine 33:E6–E9PubMedCrossRef

46.

White AA, Panjabi MM (eds) (1990) Clinical biomechanics of the spine, 2nd edn. JB Lippincott, Philadelphia

47.

Zhao Y, Sun Y, Chen Z, Liu Z (2010) Application of cervical arthroplasty with Bryan cervical disc: long-term X-ray and magnetic resonance imaging follow-up results. Chin Med J 123(21):2999–3002PubMed

48.

FDA Summary of Safety and effectiveness data (SSED) (2007) PRESTIGE Cervical Disc System, PMA P060018, Date of FDA Notice of Approval: July 16 2007

49.

Pickett GE, Rouleau JP, Duggal (2005) Kinematic analysis of the cervical spine following implantation of an artificial cervical disc. Spine 30(17):1949–1954PubMedCrossRef

50.

Mummaneni PV, Burkus JK, Haid RW, Traynelis VC, Zdeblick TA (2007) Clinical and radiographic analysis of cervical disc arthroplasty compared with allograft fusion: a randomized controlled clinical trial. J Neurosurg Spine 6(3):198–209PubMedCrossRef

51.

Bertagnoli R, Duggal N, Pickett GE, Wigfield CC, Gill SS, Karg A, Voigt S (2005) Cervical total disc replacement, part two: clinical results. Orthop Clin N Am 36:355–362CrossRef

52.

Janssen M, Goldstein J, Murrey D, Delamarter R (2007) Heterotopic ossification at the index level after Prodisc-C: what is the clinical significance? Spine J 7:48–49CrossRef

53.

Amevo B, Worth D, Bogduk N (1991) Instantaneous axes of rotation of the typical cervical motion segments: a study in normal volunteers. Clin Biomech 6:111–117CrossRef

Titel: Does sagittal position of the CTDR-related centre of rotation influence functional outcome? Prospective 2-year follow-up analysis
verfasst von: P. Suchomel
L. Jurák
J. Antinheimo
J. Pohjola
J. Stulik
H.-J. Meisel
M. Čabraja
C. Woiciechowsky
B. Bruchmann
I. Shackleford
R. Arregui
S. Sola
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 5/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-014-3223-0

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2014

How can we optimize anterior iliac crest bone harvesting? An anatomical and radiological study

Announcements for issue 5, 2014

Increased intraoperative epidural pressure in lumbar spinal stenosis patients with a positive nerve root sedimentation sign

Is the 4 mm height of the vertebral artery groove really a limitation of C1 pedicle screw insertion?

Identification of intervertebral disc regeneration with magnetic resonance imaging after a long-term follow-up in patients treated with percutaneous diode laser nucleoplasty: a retrospective clinical and radiological analysis of 14 patients

Minimally invasive surgery for lumbar disc herniation: a systematic review and meta-analysis