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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Operational demographics and clinical results of 100 consecutive artificial cervical disc replacements

Operationsstatistik und klinische Ergebnisse von 100 aufeinanderfolgenden künstlichen zervikalen Bandscheibenersatz

Meeting Abstract

  • corresponding author H. Poimann - Neurochirurgische Gemeinschaftspraxis Würzburg
  • K. Thießen - Rotkreuzklinik Würzburg
  • H. Fröhlich - Neurochirurgische Gemeinschaftspraxis Würzburg
  • J. Harth - Neurochirurgische Gemeinschaftspraxis Würzburg
  • M. Schaefer - Neurochirurgische Gemeinschaftspraxis Würzburg

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocMI.07.04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc246.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Poimann 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: Prospective, consecutive series of 100 patients with prosthetic implantations, who were enrolled between four different kinds of prosthesis. Operative demographics and clinical result of 80 single level cervical disc replacements and 20 two level operations were investigated. A second aim was to compare both clinical success as well as operative demographics with the known figures in the current literature.

Methods: Surgery was performed at no more than 2 continuous levels by four experienced neurosurgeons. 100 unselected consecutive patients suffering from radiculopathy or myelopathy due to degenerative disc disease/cervical spondylosis underwent disc replacement. Mean follow-up time was 16 months. We evaluated intraoperative blood loss, length of surgery, perioperative complications, the learning-curve of the surgeons and the patients’ neurological and functional outcomes.

Results: The four types of prosthesis (49 Spinal kinetics and 22 Bryan, 19 Pro Disc, 10 Prestige) two level prosstheses were used 8 times, single level disc replacements in 80 cases and 12 hybrid solutions.

The is no significant difference between the four typs of prostheses (p.<.05).

Compared to results reported in literature, (1-6) there are no real differences in regard to other series of disc replacement or results regarding the anterior cervical discectomy and fusion (ACDF). There is no noticeable ossification and there is a good range of motion as shown by functional x-rays.

Operative demographics showed a length of surgery of 120 (±26) minutes, a measured blood loss of 91 (±116.49) ml and 2 % tissue lesions.

32 % of the patients were without any complaints, 42 % without neckpain, 76 % without radiculopathy, 46 patients did not need any more treatment by a doctor and 51 % did not take any medication at all. The VAS improved from 8.08 to 2.02 after operation.

The odoms were excellent in 59 %, good in 22 %, fair in 10 % and showed poor results in 9 %. 89 patients went back to work and 11 patients retired.

Over-all-patients satisfaction with surgery was 6.17(on a scale 1 (poor)- 7 (excellent)) 89.47 % would choose the same treatment again. There were no persisting neurologic defects in respect to muscular paresis; disturbation of sensation persisted in 14 %.

Conclusions: Disc replacement is a safe procedure with very good clinical and functional results. It provides an excellent alternative to fusion regarding the individual patient’s preoperative situation. In order to prove the superiority of artifical disc replacement to ACDF, large trials with strict randomisation are still required.