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Clinical and radiological outcome of a new total cervical disc replacement design

  • 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 outcomeStudy 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.zeige mehrzeige weniger

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Metadaten
Verfasserangaben:Christoph MehrenORCiDGND, Franziska Heider, Daniel Sauer, Ralph Kothe, Andreas Korge, Wolfgang HitzlORCiD, Karin Würtz-KozakORCiDGND
DOI:https://doi.org/10.1097/BRS.0000000000002799
ISSN:0362-2436
ISSN:1528-1159
Pubmed ID:https://pubmed.ncbi.nlm.nih.gov/30020276
Titel des übergeordneten Werks (Englisch):Spine
Verlag:Lippincott Williams & Wilkins
Verlagsort:Philadelphia
Publikationstyp:Wissenschaftlicher Artikel
Sprache:Englisch
Datum der Erstveröffentlichung:28.06.2018
Erscheinungsjahr:2019
Datum der Freischaltung:07.04.2021
Freies Schlagwort / Tag:ProDisc Vivo; heterotopic ossifications; implant-related complications; outcomes; total disc arthroplasty; total disc replacement
Band:44
Ausgabe:4
Seitenanzahl:9
Erste Seite:E202
Letzte Seite:E210
Organisationseinheiten:Humanwissenschaftliche Fakultät / Strukturbereich Kognitionswissenschaften / Department Sport- und Gesundheitswissenschaften
DDC-Klassifikation:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
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