gms | German Medical Science

61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

Is dynamic cervical disc replacement an alternative to ACDF? A two-year follow-up study

Meeting Abstract

  • Jörg Herdmann - Klinik für Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf, Deutschland
  • Peter Buddenberg - Klinik für Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf, Deutschland
  • Sascha Rhee - Klinik für Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf, Deutschland
  • Albrecht Pilz - Klinik für Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf, Deutschland
  • Frank Floeth - Klinik für Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1683

DOI: 10.3205/10dgnc154, URN: urn:nbn:de:0183-10dgnc1548

Veröffentlicht: 16. September 2010

© 2010 Herdmann 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 vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The aim of most new implants for cervical disc replacement is to maintain or restore function. The Dynamic Cervical Implant (DCI™, Paradigm Spine) aims at combining the advantages of the gold standard fusion technique with the motion preservation philosophy. DCI has a limited motion: it works like a shock absorbing spring and may help to slow down adjacent segment degeneration.

Methods: Between 2007 and 2010 we selected 79 patients aged 32 to 73 years for treatment with DCI at either one or two levels (10 patients). Indications were radiculopathies (n=45), axial pain (n=4) or spondylotic spinal stenosis (n=30) without chronic myelopathy. Patients are followed up at 3, 6, 12, and 24 months after surgery using NDI, pain and satisfaction questionnaires and SF12.

Results: Disc surgery was performed at C3/C4 (n=2), C4/5 (n=6), at C5/6 (n=43), C6/7 (n=37) and at C7/T1 (n=1). In flexion/extension radiographs motion rapidly increased after surgery. However, 5 of 19 treated levels were fused (seen at 6 or 12 months). After implant footprint was changed and larger sizes were provided only 2 of 67 segments fused. Still 96% of the patients rated their clinical result as excellent or good. There were no implant related complications or revision surgery. Neck pain, arm pain, and NDI continuously decreased in successive follow-ups. Correspondingly all satisfaction scores continuously increased.

Conclusions: Disc replacement with DCI is a new strategy that is positioned in between anterior cervical fusion and disc prosthesis. The change of implant footprint has significantly reduced fusion-rate. Clinical results are as good as in anterior cervical fusion until 12 months follow-up. They tend to be better than fusion at 24 months follow-up. Possibly adjacent segment protection is liable for this improvement. We will continue to follow-up DCI-patients for the next years in order to validate these findings.