TY  - JOUR
A1  - Mehren, Christoph
A1  - Heider, Franziska
A1  - Sauer, Daniel
A1  - Kothe, Ralph
A1  - Korge, Andreas
A1  - Hitzl, Wolfgang
A1  - Würtz-Kozak, Karin
T1  - Clinical and radiological outcome of a new total cervical disc replacement design
T2  - Spine
N2  - Study Design. A nonrandomized, prospective, and single- center clinical trial of the ProDisc Vivo prosthesis. Objective. The aim of this study was to investigate the clinical and radiological results of a refined total cervical disc replacement (cTDR), the ProDisc Vivo, with two years of follow-up (FU). The incidence of implant-related complications was recorded as a secondary outcome variable. Summary of Background Data. Previous generations of the ProDisc artificial cervical disc replacement generate high primary stability due to keel-based designs with opening of the anterior cortex during the implantation and subsequent high rates of heterotopic ossifications. Methods. Clinical outcome scores included the Neck Disability Index (NDI), Visual Analogue Scale (VAS), arm and neck pain self-assessment questionnaires. The radiological outcome included the range of motion (ROM) and the occurrence of heterotopic ossifications. The incidence of implant-related complications with new implant design was recorded as a secondary outcome variable. Results. A total of 55 patients received a single-level treatment with the ProDisc Vivo cTDR between C3/4 and C6/7, with a follow-up rate of 78%. The clinical outcome scores improved in all parameters significantly (P 1/4 0.0001) (NDI: 68.3 -> 17.4; VAS arm: 6.3 -> 1.4; VAS neck: 4.9 -> 1.6). The ROM of the indexsegment did not show a significant change (P 1/4 0.26) (7.9 degrees -> 9.2 degrees). Heterotopic ossifications at the index segment was found as grade 0 in 5%, grade 1 in 22%, grade 2 in 10%, grade 3 (with functional impairment of the prosthesis) in 7%, and grade 4 in 3% of the cases. We observed three implant-related complications (5.5%), with two implant dislocations anteriorly and one low-grade infect. Conclusion. cTDR with ProDisc Vivo demonstrated a significant and sustained improvement of all clinical outcome parameters. A less invasive implantation mechanism with lower primary stability of the cTDR might be a reason for a higher dislocation rate than the keel-based previous generation ProDisc C.
KW  - heterotopic ossifications
KW  - implant-related complications
KW  - outcomes
KW  - ProDisc Vivo
KW  - total disc arthroplasty
KW  - total disc replacement
Y1  - 2018
UR  - https://publishup.uni-potsdam.de/frontdoor/index/index/docId/50214
SN  - 0362-2436
SN  - 1528-1159
VL  - 44
IS  - 4
SP  - E202
EP  - E210
PB  - Lippincott Williams & Wilkins
CY  - Philadelphia
ER  -