Title: Radiographic, longitudinal follow-up after treatment of cervical single-level disc disease with the Bryan Cervical Disc Prosthesis
Authors: Walraevens, Joris
Vander Sloten, Jos
Demaerel, Philippe
Suetens, Paul
van Loon, Johan
Goffin, Jan #
Issue Date: Sep-2009
Host Document: European Spine Journal vol:18 pages:S403-S404
Conference: Eurospine location:Warsaw, Poland date:21-24 October 2009
Article number: 2
Abstract: STUDY DESIGN: A prospective long term, longitudinal, radiographic follow-up study of the Bryan Cervical Disc Prosthesis (Medtronic, Memphis, TN, USA) was performed in patients treated for single-level degenerative disc disease.
OBJECTIVES: This study assesses the change in motion at the index level and the change in motion and disc degeneration at the adjacent levels over time.
BACKGROUND: Previous studies have shown that the prosthesis is able to remain mobile at intermediate follow-up. It is hypothesized that this mobility protects against an abnormal increase in adjacent level motion resulting in an accelerated degeneration of those levels, as seen after interbody fusion. However, data is lacking on how the mobility of the index level and adjacent levels and how degeneration of the adjacent levels evolves over time.
METHODS: Patients were included in this follow-up study, if their preoperative range of motion (ROM) at the index level was >2°. Intervertebral disc degeneration was assessed using an objective and validated scoring system ranging from 0 (no degeneration) to 9 (severe degeneration). Based on lateral radiographs, ROM was calculated using a custom motion analysis tool (measurement error: 0.3°).
RESULTS: In total, 71 patients were included. In March 2009, 67 patients had 4 years, 65 had 6 years, and 18 had 8 years radiographic follow-up. On average, preoperative ROM was 9.7+/-5.2° at index level, and 11.7+/-4.6° and 10.0+/-5.0° at the cranial and caudal adjacent levels. As seen in figure 1, at index level ROM stabilized slightly above the preoperative value at 4 year, 6 year and 8 year follow-up (p>0.05). At the adjacent levels, a similar trend was observed (p>0.05).
On average, the preoperative degeneration score was 2.4+/-2.0 at the index level, 1.1+/-1.5 at the cranial and 0.8+/-1.4 at the caudal adjacent level. As seen in figure 2, the degeneration score at the adjacent levels increased not abnormally at 4 year, 6 year and 8 year follow-up. There was a significant correlation between preoperative and postoperative degeneration for both adjacent levels (r>0.76).
CONCLUSIONS: ROM at the index level is maintained up to 8 years after surgery. Moreover, the insertion of the prosthesis did not lead to an abnormal increase in ROM of the adjacent levels. The Bryan Cervical Disc Prosthesis seems to protect against acceleration of adjacent level degeneration as seen after interbody fusion.
Description: Walraevens J., Vander Sloten J., Demaerel P., Suetens P., van Loon J., Goffin J., ''Radiographic, longitudinal follow-up after treatment of cervical single-level disc disease with the Bryan Cervical Disc Prosthesis'', European spine journal, vol. 18, pp. S403-S404, 2009 (Eurospine, October 21-24, 2009, Warsaw, Poland).
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Biomechanics Section
Research Group Experimental Neurosurgery and Neuroanatomy
ESAT - PSI, Processing Speech and Images
Translational MRI (+)
# (joint) last author

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