gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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BRYAN cervical arthroplasty at K.H.M.C. – Retrospective evaluation

Meeting Abstract

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  • Rami Alqroom - Royal medical services, KHMC, Neurosurgery Department. Amman, Jordan
  • Nidal Khasawneh - Royal medical services, KHMC, Neurosurgery Department. Amman, Jordan
  • Mohamd Alhosban - Royal medical services, KHMC, Neurosurgery Department. Amman, Jordan
  • Feras Haddad - Royal medical services, KHMC, Neurosurgery Department. Amman, Jordan
  • Anas Dyab - Royal medical services, KHMC, Neurosurgery Department. Amman, Jordan
  • Hussam Abu-Nowar - Royal medical services, KHMC, Neurosurgery Department. Amman, Jordan

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocP 126

doi: 10.3205/14dgnc522, urn:nbn:de:0183-14dgnc5222

Published: May 13, 2014

© 2014 Alqroom 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

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Objective: The purpose of this retrospective study is to evaluate long-term results after cervical disc arthroplasty (BRYAN).

Method: We performed a retrospective review of patients presenting with spondylotic cervical myelopathy or radiculopathy and underwent cervical disc arthroplasty (BRYAN) between JAN.2004 and JAN.2010 and had a minimum follow-up of 27 months. Radiographic follow-up included static and flexion/extension radiographs. Changes in the operated segments were compared to radiographs directly after surgery. Clinical outcome was evaluated by a physical exam, pain VAS and NDI.

Results: 112 patients were operated. The mean age at presentation was 51 years (Range 42-65), 69 patients were male (61.6%). 43 female (38.4%) and all patients had one level surgery. Minimal Follow of 24 months.74 patients presented with radiculopathy (66%), 38 with myelopathy (34%). Over all 98 patients presented with limb pain. Pain resolved or improved in 87 (88.7%) cases. Mean VAS declined from 7, 3 average to 2, 1 and NDI from 32 to 14 in one-level surgeries, respectively. Myelopathy was unchanged in 5 (13,1%), worse in 4 (10,5%); 29 patients improved (76,3%). In 10 patiens (8,9%) we achieved correction of kyphosis. Regarding motion and subsidence at operated levels, no subsidence observed at 24 follow-up in all cases preserved motion except of cases of dislodgment and ossification. Overall there were 2 (0,17%) cases of ossification. There was one case of disc displacement and one case of injury to the vertebral artery.

The most common segment treated for myelopathic symptoms was C4/C5 (55%) and the most common segments treated for disc herniation were C5/C6 (52%) and C6/C7 (48%).

Conclusions: Although ACDF is the gold standard procedure for treatment of cervical disc pathology with established safety and effectiveness, however the evolved alternative arthroplasty (BRYAN) eliminates restrictions and limitations by preserving motion and avoiding new adjacent level pathology.