gms | German Medical Science

55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Segmental motion and cervical alignment after implantation of the bryan cervical disc prothesis

Segmentale Beweglichkeit und HWS-Lordose nach Implanation der Bryan HWS-Bandscheibenprothese

Meeting Abstract

Suche in Medline nach

  • corresponding author Massimo Leonardi - Neurochirurgische Abteilung, Städtisches Krankenhaus München Bogenhausen, Englschalkinger Str. 77, 81925 München
  • W. Gerstner - Neurochirurgische Abteilung, Städtisches Krankenhaus München Bogenhausen, Englschalkinger Str. 77, 81925 München
  • C. B. Lumenta - Neurochirurgische Abteilung, Städtisches Krankenhaus München Bogenhausen, Englschalkinger Str. 77, 81925 München

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.13.05

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0129.shtml

Veröffentlicht: 23. April 2004

© 2004 Leonardi et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Anterior cervical discectomy with fusion has proved to resolve radicular pain and improve neurological deficit, when it is due to compression of neural structures. Complications after fusion are pseudoarthrosis and adjacent level disease due to increased stress. Further, loss of lordosis or maintainment of malalignment of the cervical spine may occur after fusion, which can cause persistent neck pain. Artificial disc replacement should maintain motion in the operated segment and therefore reduce stress in the adjacent level. Small series with short follow-up periods could not confirm the benefits of an artificial joint in the cervical spine until now.

Methods

Seventeen patients (mean age 44,9 years) underwent single level anterior discectomy and implantation of the Bryan Cervical Disc Prothesis and were followed prospectively. Clinical outcome was evaluated according to Odoms`s criteria. Follow-up ranged from 2 to 19 months (mean 12 months). Follow-up of alignment of the cervical spine was measured by subjective classification (lordosis, straight, kyphosis) and with the posterior tangent angles and compared to persistent neck pain. Motion was evaluated in flexion and extension radiographs with the Penning method and segmental Cobb angles.

Results

Neuroradiological pathologies were, in 10 cases, soft disc heniation, in 9 cases stenosis and in 13 cases spondylosis. Radicular pain were present in 16 cases, sensory deficit in 13 deficit and in 2 cases motor deficit. According to Odom`s criteria 3 patients were graded as excellent, and 10 as good, 3 patients did fair and 1 patient had a poor result. Follow-up showed no progression of degeneration in the adjacent levels. No bridging bone or fusion were observed. Postoperatively 2 cases improved from straight alignment to lordosis and 2 further from kyphosis to lordosis. Mean postoperative cervical tangent angles changed from 9,5° to 9,0°. In total 6 patients maintained some degree of neck pain. In all operated segments postoperatively motion was maintained, mean range of motion was 5,7°. Range of motion of adjacent upper and lower segment was 17° and 12,75° postoperatively.

Conclusions

Early clinical outcome after placement of cervical disc prothesis is comparable to discectomy with fusion. In a subgroup of patients neck pain persisted, even though some of these had improvement of alignment. Even though at this time follow-up period is short, preliminary results showed that no adjacent level becomes symptomatic and no operation for adjacent level degeneration was necessary. Motion had been preserved in the operated segments. Long term follow-up studies will be required to determine if changes in adjacent level movement can influence the natural history.