CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(02): 185-190
DOI: 10.1055/s-0039-3400526
Artigo Original
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Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Results of Total Cervical Disc Replacement with a Minimum Follow-up of 10 Years[*]

Article in several languages: português | English
1  Departamento de Ortopedia, Hospital São João, Porto, Portugal
,
Daniela Vilas Boas Rosa Linhares
1  Departamento de Ortopedia, Hospital São João, Porto, Portugal
,
José Miguel Monteiro Lopes
1  Departamento de Ortopedia, Hospital São João, Porto, Portugal
,
Pedro Cacho Rodrigues
1  Departamento de Ortopedia, Hospital São João, Porto, Portugal
,
Rui Peixoto Pinto
1  Departamento de Ortopedia, Hospital São João, Porto, Portugal
,
Nuno Silva Morais Neves
2  Serviço de Ortopedia, Centro Hospitalar de São João, Porto, Portugal
3  Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
4  Instituto de Investigação i Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal
› Author Affiliations
Further Information

Publication History

29 June 2018

22 January 2019

Publication Date:
19 December 2019 (online)

Abstract

Objective In the present study, we present the results with at least 10 years of follow-up of the cervical disc prosthesis implanted in a single level.

Methods Retrospective study of patients undergoing single-level total cervical disc replacement (TCDR). Clinical results included the neck disability index (NDI) and the visual analogue scale (VAS) in the preoperative period, one year postoperatively, and a minimum of 10 years of follow-up. The radiographic parameters included cervical mobility, segmental lordosis, C2-C7 angle, heterotopic ossification (HO), facet and joint degeneration (FJD) and adjacent segment disease (ASD).

Results We identified 22 patients, 16 women and 6 men with mean age of 39.7 years old (26–51 years old), of which fifteen completed a minimum follow-up of 10 years. There was a statistically significant improvement of NDI and VAS (p < 0.001) between the preoperative and the postoperative periods (1 year or > 10 years). At the end of 10 years, HO was observed in 59% of the cases. The mobility of the implant was preserved in 80% of the patients. Radiological evidence of ASD was recorded in 6 patients (40%). There was no correlation between the clinical parameters evaluated and the presence of ASD or the different classes of HO.

Conclusion Clinical improvement in all evaluated parameters, which persists over time. Most implants maintained mobility, as has already been demonstrated in other studies with shorter follow-ups. In a significant percentage of cases, ASD was observed, questioning the concept of motion preserving technology. However, we did not have any surgical intervention for this reason, since there was no correlation with worse clinical results.

* Study conducted at the Department of Orthopedics, Hospital São João, Porto, Portugal.