Clinical and Radiological Review of a Semi-Constrained Cervical Disc Replacement with a Ceramic-Ceramic Articulation with a Minimum Seven Years Follow-Up
Abstract
PURPOSE OF THE STUDY Artificial cervical disc replacement (CDR) has emerged as a viable treatment alternative to fusion for the management of symptomatic compressive radiculopathy and potentially for cervical myelopathy. The aim of our study was to evaluate the clinical and radiological outcomes of patients treated with a second generation semi-constrained CDR with a ceramicceramic articulation.
MATERIAL AND METHODS A prospective cohort study of all patients undergoing a cervical disc replacement for cervical disc pathology, during the period from April 2007 to April 2011 using a ceramic-ceramic disc replacement comprised the study group. 52 patients were available for final clinical and radiological follow-up. Both, clinical and radiological evaluation were performed at each clinical visit at 6 weeks, 6 months, 12 months, 2 years, 5 years and 7 years.
RESULTS There were a total of 52 patients, with 44 single level cases and 8 two level cases. The NDI improved significantly (p < 0.05) from a mean preoperative score of 56 % to a score of 20% at final follow-up.
The mean preoperative mobility at the index level unit was 12.2 +/- 4.5 degrees, this decreased to 7.9 +/- 3.2 degrees at six weeks, but slightly increased to 12.9 +/- 2.9 degrees at final follow-up (gain not significant). Heterotrophic ossification (HO) was noted in 13 (25%) patients.
CONCLUSIONS Cervical disc replacement with a ceramic-ceramic bearing surface is a viable option in the treatment of variety of cervical pathologies. This ceramic-ceramic interface may eliminate the potential problems of metallosis and poly-wear but further longer-term results should be studied.