Mobi-C cervical disc replacement: a five-year follow-up report in 19 cases

doi:10.3969/j.issn.2095-4344.2015.39.011

Abstract

Abstract:

BACKGROUND: Anterior cervical discectomy and intervertebral disc replacement have been extensively used in treatment of cervical degenerative disease. Its short-term therapeutic effects are encouraging, but it lacks of long-term and comprehensive evaluation.
OBJECTIVE: To observe the follow-up results of a group of cases of anterior cervical discectomy and Mobi-C intervertebral disc replacement for more than 5 years.
METHODS: A total of 25 cases of cervical spondylosis were treated in the 309 Hospital of Chinese PLA from January to September 2009. 19 of them were followed up. All patients received anterior cervical discectomy and Mobi-C intervertebral disc replacement. Twenty-three Mobi-C intervertebral disc prostheses were implanted. The range of motion was measured using lateral X-ray films during extension and flexion. Ectopic ossification was assessed by McAfee method. According to the cervical vertebra MRI images, the degeneration of adjacent segments was determined using Pearce classification. NDI score was used to evaluate the function of cervical spine. Pain improvement was evaluated using visual analogue scale score.
RESULTS AND CONCLUSION: A total of 19 patients were followed up for 59-65 months, averagely 62 months. No significant difference in range of motion was detected before surgery and during final follow-up (P > 0.05). Ectopic ossification in two cases and the degeneration of adjacent segments in one case were found during final follow-up. No prosthesis loosening or displacement appeared. Visual analogue scale score and NDI score were significantly lower during final follow-up compared with that before surgery (P < 0.05). These results indicate that under the premise of reasonable choice of indications, the therapeutic effect of Mobi-C intervertebral disc replacement for degenerative cervical spondylosis was satisfactory in five-year follow-up. The range of motion was good, and the incidences of ectopic ossification and the degeneration of adjacent segments were low.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, Replacement, Cervical Vertebrae, Follow-Up Studies

CLC Number:

R318

Bao Da, Ma Yuan-zheng, Chen Xing. Mobi-C cervical disc replacement: a five-year follow-up report in 19 cases[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2015.39.011.

Figures/Tables 1

References

[1] Hilibrand AS,Carlson GD, Palumbo MA, et al. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg (Am).1999; 81(4):519-528.
[2] 李超,阮狄克,徐成,等.颈椎前路融合对相邻节段影响的生物力学研究与临床短期观察[J].中国脊柱脊髓杂志,2008,18(1): 28-31.
[3] Katsuura A, Hukuda S, Saruhashi Y, et al. Kyphotic malalignment after anterior cervical fusion is one of the factors promoting the degenerative process in adjacent interventebral levels. Eur Spine J.2001;10(4):320-324.
[4] 荆珏华,田大胜,钱军,等.颈椎融合内固定对相邻节段椎间盘及椎间关节压力影响的生物力学研究[J].颈腰痛杂志,2009,30(3): 200-202.
[5] 丁琛,刘浩,胡韬,等.Bryan人工颈椎间盘置换治疗颈椎病的中期临床随访[J].中国组织工程研究与临床康复,2011,15(17): 3047-3052.
[6] Goffin J, van Loon J, Van Calenbergh F, et al.A clinical analysis of 4- and 6-year follow-up results after cervical disc replacement surgery using the Bryan Cervical Disc Prosthesis.J Neurosurg Spine. 2010;12(3):261-269.
[7] Bakhtadze MA, Vernon H, Zakharova OB,et al.The Neck Disability Index-Russian Language Version (NDI-RU): A Study of Validity and Reliability.Spine (Phila Pa 1976). 2015;40(14): 1115-1121.
[8] Christian WA, Alexander M, Marco Z, et al. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 2001; 26(12): 1873-1878.
[9] McAfee PC,Cunningham BW, Devine J, et al. Classification of heterotopic ossification(HO) in artificial disk replacement. J Spinal Disord Tech. 2003;16(4):384-389
[10] Lee SE, Chung CK, Jahng TA. Early development and progression of heterotopic ossification in cervical total disc replacement. J Neurosurg Spine. 2012;16(1):31-36.
[11] Lee JH, Jung TG, Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement. Spine J.2010;10(8): 676-682.
[12] 孙宇,赵衍斌,周非非,等.Bryan颈椎人工椎间盘置换术后5年随访结果[J].中国脊柱脊髓杂志,2012,22(1):1-7.
[13] Hacker B. Bryan disc related cervical kyphosis. Spine J. 2007; 7(1):138-139.
[14] Shim CS, Shin HD, Lee SH. Posterior avulsion fracture at adjacent vertebral body during cervical disc replacement with Prodisc-C. J Spinal Disord Tech. 2007;20(6):468-472.
[15] Suchomel P, Jurak L, Benes V, et al. Clinical results and development of heterotopic ossification in total disc replacement during a 4-year follow-up. Eur Spine J. 2010; 19(2): 307-315.
[16] 任先军,王卫东,初同伟,等.椎间盘置换联合邻近节段cage融合治疗双节段颈椎间盘突出症的近期疗效[J].中国脊柱脊髓杂志, 2009,19(11):840-844.
[17] Park DK, Lin EL, Phillips FM. Index and adjacent level kinematics after cervical disc replacement and anterior　fusion: in vivo quantitative radiographic analysis. Spine. 2011;36(9): 721-730.
[18] 孙宇,赵衍斌,周非非,等.颈椎人工椎间盘置换后对相邻节段退变的影响[J].中国脊柱脊髓杂志.2011,21(6):474-479.
[19] Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J. 2009; 18(2):218-231.
[20] Laxer EB, Darden BV, Murrey DB, et al. Ajacent segment disc pressure following two-level cervical disc replacement versus simulated anterior cervical fusion. Stud Health Technol Inform. 2006;123:488-492.
[21] Puttlitz CM, Rousseau MA, Xu Z, et al. Intervertebral disc replacement maintains cervical spine kinetics. Spine.2004; 29(24):2809-2814.
[22] Dmitriev AE, Cuiningham BW, Hu N, et al. Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine.2005;30(10):1165-1172.
[23] Barrey C, Campana S, Persohn S, et al. Cervical disc prosthesis versus arthrodesis using one-level, hybrid and two-level constructs: an in vitro investigation. Eur Spine J. 2012;21(3):432-442.