Qingpeng Song1, Da He1, Xiao Han1, Ning Zhang1, Jinchao Wang1, Wei Tian2. 1. Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing, China. 2. Department of Spine Surgery, Beijing Jishuitan Hospital, The Fourth Clinical College of Peking University, No. 31 Xinjiekou East Street, Xicheng District, Beijing, China. weitianjstspine@126.com.
Abstract
PURPOSE: Previous studies have demonstrated that cervical disc arthroplasty has favourable short- and medium-term clinical and radiological outcomes. However, long-term follow-up outcomes have rarely been reported. The purpose of this study was to evaluate the ten year follow-up clinical and radiological outcomes in patients who underwent Bryan cervical disc arthroplasty. METHODS: Seventy-one patients who underwent single-level Bryan cervical disc arthroplasty with a minimum ten year follow-up were included in the study. Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom's criteria were used to evaluate clinical outcomes. X-ray, CT, and MRI were used to evaluate the radiological outcomes. RESULTS: At last follow-up, the JOA score and NDI improved significantly, and 65 patients (91.5%) had good or excellent outcomes according to Odom's criteria. The range of motion (ROM) at operated level was 9.7° pre-operatively and maintained to 8.6° at last follow-up. The sagittal alignment of operated level was decreased from 2.1° pre-operatively to 1.2° at last follow-up (P < 0.01). The ROM and sagittal alignment of cervical spine had no significant change. At last follow-up, 16 patients (22.5%) developed segmental kyphosis, and 33 patients (46.5%) developed adjacent segment degeneration. Paravertebral ossification (PO) was observed in 66 patients (93.0%), and high-grade PO (grades III and IV) was observed in 25 patients (35.2%). CONCLUSIONS: The clinical and radiological outcomes of Bryan cervical disc arthroplasty over ten years follow-up are satisfying. However, the occurrence of high-grade PO restricted the ROM of operated level.
PURPOSE: Previous studies have demonstrated that cervical disc arthroplasty has favourable short- and medium-term clinical and radiological outcomes. However, long-term follow-up outcomes have rarely been reported. The purpose of this study was to evaluate the ten year follow-up clinical and radiological outcomes in patients who underwent Bryan cervical disc arthroplasty. METHODS: Seventy-one patients who underwent single-level Bryan cervical disc arthroplasty with a minimum ten year follow-up were included in the study. Japanese Orthopaedic Association (JOA) score, neck disability index (NDI), and Odom's criteria were used to evaluate clinical outcomes. X-ray, CT, and MRI were used to evaluate the radiological outcomes. RESULTS: At last follow-up, the JOA score and NDI improved significantly, and 65 patients (91.5%) had good or excellent outcomes according to Odom's criteria. The range of motion (ROM) at operated level was 9.7° pre-operatively and maintained to 8.6° at last follow-up. The sagittal alignment of operated level was decreased from 2.1° pre-operatively to 1.2° at last follow-up (P < 0.01). The ROM and sagittal alignment of cervical spine had no significant change. At last follow-up, 16 patients (22.5%) developed segmental kyphosis, and 33 patients (46.5%) developed adjacent segment degeneration. Paravertebral ossification (PO) was observed in 66 patients (93.0%), and high-grade PO (grades III and IV) was observed in 25 patients (35.2%). CONCLUSIONS: The clinical and radiological outcomes of Bryan cervical disc arthroplasty over ten years follow-up are satisfying. However, the occurrence of high-grade PO restricted the ROM of operated level.
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