Artikel
Long-term follow-up after implantation of cervical disk prostheses
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Autoren
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Joellenbeck Boris
- Klinik für Neurochirurgie, Otto-von-Guericke Universität Magdeburg, Deutschland
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Raimund Firsching
- Klinik für Neurochirurgie, Otto-von-Guericke Universität Magdeburg, Deutschland
| Veröffentlicht: | 16. September 2010 |
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Gliederung
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Objective: By now the implantation of cervical disk prostheses has become common practice. Various implants
are available. The object of all these implants is to preserve motion and to protect the adjacent levels from the wear and tear caused by fusion. Recent reports have demonstrated no increased risk from the implantation of disk prostheses as compared to fusion and no difference of outcome. The protective effect of the cervical disk prosthesis on the adjacent levels remains unclear in the absence of long-term follow-up studies as of yet.
Methods: 196 prostheses were implanted in 185 patients, 103 female 72 male, from May 2002 until December 2007. Inclusion criteria for the artificial disk was age below 65 years and a demonstrated movement of the segment on lateral x-ray in inclination and extension. Follow-up included registration of neurological findings, the ODOM score, the visual analogue scale for assessment of pain, the neck pain disability index and ossification, Aebi I to IV, and the range of motion as documentated by x-ray 3 to 5 years after operation.
Results: Resolution of pain and neurological disorders were exellent and good in 82%, 15% had to be classified as fair, 3% as poor. A preserved motion of the operated segment was documented in 72%. Median range of motion was 7,9 degrees. Heterotopic ossification was found in 26%. In two cases operation in case of adjacent level disease became necessary. In 13 cases a second operation at an adjacent level had to be performed in patients with degenerative disk disease of the adjacent level identified prior to the first operation. There was no single case with infection or dislocation of the implant. Patient satisfaction with the procedure was 90%.
Conclusions: The implantation of cervical disk prostheses is not associated with increased risk as compared to fusion. Long-term preservation of motion was documented in 72% of the cases. There was no case with the onset of adjacent level disease after implantation of the prosthese, whwn the rate of motion was preserved.
