Clinical Experience of the First 20 Prestige LP Cervical Arthroplasties

Cervical Disc ARTHROPLASTY with Prestige LP Cervical Disc Replacement

 

SUMMARY

For all 20 patients: neurological symptoms significantly improved

JOA SCORE

NURICK SCORES

SUMMARY DATA

 

Short term results as regards relief of radicular or myelopathic symptoms comparable to those from ACDF

Minimal Subsidence

No evidence for H.O. of any evidence of spontaneous fusion in this series

Literature up to 9.1% spontaneous fusion

 

Heterotopic Ossification in Total Cervical Artificial Disc Replacement. Spine. 31(24):2802-2806, November 15, 2006.
Mehren, Christoph MD *; Suchomel, Petr MD, PhD +; Grochulla, Frank MD *; Barsa, Pavel MD +; Sourkova, Petra MD +; Hradil, Jan MD +; Korge, Andreas MD *; Mayer, H Michael MD, PhD *

 

COMPARED TO ACDF:

 

Wider Uncinate Resection

Spondylotic Ridge Resection

Retention of MOTION may lead to RECURRENCE of Spondylosis as compared to fusion.

 

 

Treatment of Radiculopathy with Disc Replacement

 

Literature Review:

 

Early Results of a Randomized Controlled Clinical Trial Comparing Prodisc-C and ACDF for Cervical Radiculopathy

 

Conclusion: Treatment of cervical radiculopathy with Prodisc-C disc replacement and ACDF appears to be equally safe and efficacious at early follow-up. Early range of motion postoperatively appears superior in Prodisc-C patients.

 

CSRS 2005 Eric B. Laxer, MD, Daniel B. Murrey, MD, Bruce V. Darden, MD, Alfred L. Rhyne, MD, Alden Milam, MD (Charlotte, NC), Michael E. Janssen, MD, Caroline M. Ponce, BS, Ruth Beckham, NP-C (Thornton, CO)

 

 

Artificial Disc versus Fusion for the Treatment of Cervical Radiculopathy: A Prospective, Randomized Study.

 

Conclusion: The Bryan artificial disc replacement compares very favorably to a conventional anterior cervical fusion for the treatment of patients with cervical radiculopathy.

 

CSRS 2005 Rick C. Sasso, MD, Robert Hacker, MD (Indianapolis, IN)

 

 

Proper Implant Sizing

 

Overdistraction

Increases foraminal height

BUT:

1mm overdistraction results in significantly less ROM over FSU

(NASS 2006)

Japanese Orthopedic Association (JOA) scoring system of severity of myelopathy.

<7 severe myelopathy

8-12 moderate myelopathy

>13 mild myelopathy

Nurick Score

Grade 0: signs and symptoms of root involvement but without evidence of spinal cord disease.

Grade 1: signs of spinal cord disease but no difficulty in walking.

Grade 2: slight difficulty in walking but does not prevent full-time employment.

Grade 3: severe difficulty in walking that requires assistance and prevents full-time employment and avocation.

Grade 4: ability to walk only with assistance or with the aid of a frame.

Grade 5: chairbound or bedridden.

 

 

Odoms Criteria

Excellent: All preoperative symptoms relieved; abnormal findings improved

Good: Minimal persistence of preoperative symptoms; abnormal findings unchanged of improved

Fair: Definite relief of some preoperative symptoms; other symptoms unchanged or slightly improved

Poor: Symptoms and signs unchanged or exacerbated

ASSESSMENT OF OUTCOMES

JOA Myelopathy score

Nurick Score

Odoms Criteria

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SPINE CARE HONG KONG

ACCURATE DIAGNOSIS, STRUCTURED TREATMENT