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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Complications in cervical arthroplasty: results of a two-year follow-up on patients with the PCM® (1) Disc prosthesis

Meeting Abstract

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  • J. Landscheidt - Klinik für Neurochirurgie, Klinikum München Bogenhausen
  • W. Gerstner - Klinik für Neurochirurgie, Klinikum München Bogenhausen
  • M. Krammer - Klinik für Neurochirurgie, Klinikum München Bogenhausen
  • D. Schul - Klinik für Neurochirurgie, Klinikum München Bogenhausen
  • A. Tomasino - Klinik für Neurochirurgie, Klinikum München Bogenhausen
  • C. Lumenta - Klinik für Neurochirurgie, Klinikum München Bogenhausen

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 076

doi: 10.3205/11dgnc297, urn:nbn:de:0183-11dgnc2974

Published: April 28, 2011

© 2011 Landscheidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: Different types of cervical disc arthroplasty are well-established and clinical results have been reported. There are nearly no reports and analyses about complications with this new technology. To determine the incidence of surgical complications, we analyzed our data obtained in a series of patients treated with the PCM® (1) Disc prosthesis.

Methods: We followed-up on 109 patients with the PCM-prothesis in one – three levels over a period of two years. To describe the clinical results we used the Odom Score, the VAS and the NDI and measured the segmental Cobb angle for the judgement of motion.

Results: Between 07/05–12/09 we performed surgery on 109 patients (63 female, 46 male) with a median age of 42 years (range: 24–62 years) In 16 patients (14%), more than one prosthesis was inserted. Six weeks after surgery we observed a statistically significant decrease in the VAS, the NDI and improvement according to Odoms criteria. These results maintained stable in the two-year follow-up. Segmental motion was preserved in all patients with a median result of 4° (R 1–13°) After two years, we could see no motion due to ossification in 36% of the patients. Perioperative complications were rare. We analyzed two cases of recurrent nerve paralysis; one was an esophagus perforation in a patient who had previously received radiotherapy and neither bleeding nor infection occurred. Over follow-up, we noticed 13 dislocations of the protheses, 11 of which required revision. Of these 13 patients, 8 (62% vs. 86% in the total group) had a single prothesis, 5 patients (38 % vs.14% total) received two-level surgery. We could not find any correlation between dislocation and BMI, age, gender, smoking, clinical results or degree of motion in the postoperative X-ray.

Conclusions: The PCM® prosthesis is effective for maintaining motion in the majority of patients and in producing good clinical results. Major perioperative complications were infrequent, but the incidence of dislocation is high. Strong patient selection and meticulous surgical technique, as well as improvement of the prothesis including the use of a flange are required in order to obtain good results.

(1) PCM® NuVasive, Inc.|Creative Spine Technology