Abstract:

BACKGROUND: Anterior cervical discectomy and fusion has been considered the gold standard for treatment of symptomatic degenerative disc disease within the cervical spine. However, fusion may result in progressive degeneration of the adjacent segments. Artificial disc replacement seems to be promising, segmental motion and stability are preserved while the spinal canal has been enlarged, and the intervertebral disc biological mechanics has been preserved, but not leads to progressive degeneration of the adjacent segments.
OBJECTIVE: To observe the functional outcome and kinematics after the Prodisc artificial neck intervertebral disc replacement.
METHODS: A total of 55 cases (69 intervertebral discs), 29 males and 26 females, aged 48 (31-76) years were selected, including 14 with bi-segmental injury. There were 32 cases of cervical spondylotic myelopathy, 9 of cervical spondylotic radiculopathy, and 14 of mixed type cervical spondylosis. Prodisc artificial neck intervertebral disc replacement was performed using anterior or oblique incision. Prospective data JOA score and kinematic measures were collected before surgery and at 3, 6, 12, and 24 months after surgery. Range of motion was determined by independent radiologic assessment of flexion-extension radiographs.
RESULTS AND CONCLUSION: The 55 patients were followed-up, including 41 undergoing single segmental disc replacement and 14 undergoing bi-segmental disc replacement. They were followed up for 22 (56-48) months postoperatively. JOA scores displayed improved cervical function by 56%. Range of motion of sagittal and coronal planes were similar to those prior to operation compared with preoperatively (P = 0.45, 0.74), and the range of motion and stability were maintained as adjacent segments. Results showed that the artificial disc replacement maintained range of motion of original intervertebral disc, accelerated patient recovery, and slightly affected adjacent intervertebral disc.