Srour_edit.qxp 2/5/07 10:05 am Page 58
Orthopaedic Surgery Spine
Figure 1: Preliminary Clinical Results of Assessment Questionnaires
Neck Disability Index
EVA Cervical
60
10
40
5
20
Pro Disc
Pro Disc
Bryan
Bryan
Prestige
0
0
Prestige
2m 6m 11m 15m 19m 23m 28m 2m 6m 11m 15m 19m 23m 28m
EVA Brachiale Short Form 36
12 4
10
3
8
6 2
4
1
2
Pro Disc Pro Disc
Bryan Bryan
0
Prestige
0
Prestige
2m 9m 13m 15m 19m 27m 30m 2m 9m 13m 15m 19m 27m 30m
After decompression, the depth and height of the interspace is Also, long-term analysis of radiographic findings regarding the
measured with phantoms, then the correct shaped prosthesis chosen morphologic and dynamic status of the adjacent segments is in
and inserted under radiographic control while interspace spreaders progress and has to be compared to cervical fusion.
maximally enlarge it. After removing the retractors, the stability of the
cervical spine is examined by gentle flexion of the neck. Skin closure is Conclusion
performed after closure of the platysma; drainage will normally not be There are many cervical disc prostheses currently in various stages of
necessary. After arthroplasty, no Minerva jacket is required. development and clinical usage. Although the time of this report, only
limited short-term clinical results have been presented for most of
As indicated in the tables in Figure 1, the series records an these devices, the clinical and radiographic findings are encouraging.
improvement of clinical status, especially in the Visual Analog Scale
(VAS) and in The Arm and Neck Disability Index. Furthermore, the The current review after three years of experience in cervical
comparison between those three different types of cervical disc arthroplasty, with its partial results, is guiding the authors to maintain
prosthesis shows that the results are similar. this surgical strategy with the use of devices that may have an easy
technical design for implantation with the technique of cervical fusion
However, long-term observation after five to ten years is awaited, after anterior discectomy by bone graft and/or cages. Long-term
especially in comparison with the long time practiced cervical follow up and comparison to anterior cervical discectomy and fusion
arthrodesis through bone graft or intersomatic cages. remains important. ■
1. Cummins BH, Robertson JT, Gill SS, Surgical experience with an after anterior cervical fusion and osteosynthetic stabilization for Hopkins Hosp, 1955;96:223–4.
implanted artificial cervical joint, J Neurosurg, 1998;88:943–8. fractures and/or dislocations of the cervical spine, J Spinal 9. Smith GW, Robinson RA, The treatment of certain cervicalspine
2. DiAngelo DJ, Roberston JT, Metcalf NH, et al., Biomechanical Disord, 1995;8:499–508. disorders by anterior removal of the intervertebral disc and
testing of an artificial cervical joint and an anterior cervical 6. Hilibrand AS, Carlson GD, Palumbo MA, et al., Radioculopathy interbody fusion, J Bone Joint Surg Am, 1958;40:607–24.
plate, J Spinal Disord Tech, 2003;16:314–23. and myelopathy at segments adjacent to the site of a previous 10. Wigfield C, Gill S, Nelson R, et al., Influence of an artificial
3. Goffin J, Geusens E, Vantomme N, et al., Long-term follow-up anterior cervical arthrodesis, J Bone Joint Surg Am, 1999;81: cervical joint compared with fusion on adjacent-level motion in
after interbody fusion of the cervical spine, J Spinal Disord Tech, 519–28. the treatment of degenerative cervical disc disease, J Neurosurg
2004;17:79–85. 7. Kulkarni V, Rajshekhar V, Raghuram L, Accelerated spondylotic (Spine 1), 2002;96:17–21.
4. Goffin J, Van Calenberg F, van Loon J, et al., Intermediate changes adjacent to the fused segment following central 11. Wigfield CC, Gill SS, Nelson RJ, et al., The new Frenchay
follow-up after treatment of degenerative disc disease with the cervical corpectomy: magnetic resonance imaging study artificial cervical joint: results from a two-year pilot study, Spine,
Bryan Cervical Disc Prosthesis: single-level and bi-level, Spine, evidence, J Neurosurg (Spine 1), 2004;100:2–6. 2002;27:2446–52.
2003;28:2673–8. 8. Robinson RA, Smith GW, Anterolateral cervical disc removal
5. Goffin J, van Loon J, Van Calenbergh F, et al., Long-term results and interbody fusion for cervical disc syndrome, Bull Johns
58 EUROPEAN MUSCULOSKELETAL REVIEW 2007
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