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Cervical arthroplasty

Theodore D Koreckij, Sapan D Gandhi, Daniel K Park
Anterior cervical diskectomy and fusion has been and remains the benchmark surgical management of cervical degenerative disk disease. However, an increased use of cervical disk arthroplasty (CDA) has been found in the past few years. The purported benefits of CDA included preserved motion, less adjacent-level degeneration, and less morbidity. Short-term results from randomized control trials clearly showed noninferiority of CDA compared with fusion. With long-term comparison data becoming available, results are equivalent and superior in many metrics compared, favoring CDA...
October 2, 2018: Journal of the American Academy of Orthopaedic Surgeons
Gianni R Lorello, Anahi Perlas
A 79-year-old woman with primary erythromelalgia underwent a left reverse total shoulder arthroplasty with a left interscalene nerve block, a superficial cervical plexus block, and a general endotracheal anesthetic, with no residual neurological deficits. Herein, we discuss the classification and pathophysiology of erythromelalgia along with the anesthetic considerations of peripheral nerve blockade in patients with primary erythromelalgia.
October 3, 2018: A&A practice
Vaneet Singh, Anastasia K Skipor, Abdulhafez A Selim, Joshua J Jacobs
Background: Cervical disc arthroplasty (CDA) has emerged as an alternative to anterior cervical discectomy and fusion for degenerative cervical disc disease. The artificial discs provide intervertebral motion using multicomponent articulation and thus tend to generate particulate debris and soluble metal ions. Limited information is available on the long-term metal concentrations and associated systemic adverse events observed in metal-on-metal CDA. Serum chromium (Cr) and nickel (Ni) concentrations were assessed in patients implanted with ball-in-trough stainless steel-based cervical disc through 7 years...
August 2018: International Journal of Spine Surgery
Alexander Vaccaro, William Beutler, Walter Peppelman, Joseph Marzluff, Andrew Mugglin, Prem S Ramakrishnan, Jacqueline Myer, Kelly J Baker
Background: This research was initiated to compare the long-term clinical safety and effectiveness of the selectively constrained SECURE-C (Globus Medical, Audubon, Pennsylvania) Cervical Artificial Disc to anterior cervical discectomy and fusion (ACDF). To preserve segmental motion, cervical total disc replacement (CTDR) was developed as an alternative to ACDF. Current CTDR designs incorporate constrained and unconstrained metal-on-metal or metal-on-polymer articulation with various means of fixation...
June 2018: International Journal of Spine Surgery
Leonard I Voronov, Robert M Havey, Parmenion P Tsitsopoulos, Saeed Khayatzadeh, Jeremy Goodsitt, Gerard Carandang, Alexander J Ghanayem, Avinash G Patwardhan
Background: The need for posterior longitudinal ligament (PLL) resection during cervical total disc arthroplasty (TDA) has been debated. The purpose of this laboratory study was to investigate the effect of PLL resection on cervical kinematics after TDA. Methods: Eight cadaveric cervical spine specimens were tested in flexion-extension (FE), lateral bending (LB), and axial rotation (AR) to moments of ±1.5 Nm. After testing the intact condition, anterior C5-C6 cervical discectomy was performed followed by PLL resection and implantation of a compressible, 6-degrees-of-freedom disc prosthesis (M6-C, Spinal Kinetics Inc, Sunnyvale, California)...
April 2018: International Journal of Spine Surgery
Junfeng Zeng, Hao Liu, Hua Chen, Chen Ding, Xin Rong, Yang Meng, Yi Yang
OBJECTIVE: The purpose of this study is to compare the heterotopic ossification (HO) between cervical disc arthroplasty (CDA) with fixed- and mobile-core prosthesis, and simultaneously compare the clinical and radiographic outcomes. METHODS: Retrospectively analysis the patients underwent CDA in our institute. Patients were divided into fixed-core group (Prodisc-C and Discover disc), and mobile-core group (Bryan and Prestige-LP disc). HO was assessed based on McAfee classification...
September 24, 2018: World Neurosurgery
Michael D Staudt, Doron Rabin, Ali A Baaj, Neil R Crawford, Neil Duggal
OBJECTIVE There are limited data regarding the implications of revision posterior surgery in the setting of previous cervical arthroplasty (CA). The purpose of this study was to analyze segmental biomechanics in human cadaveric specimens with and without CA, in the context of graded posterior resection. METHODS Fourteen human cadaveric cervical spines (C3-T1 or C2-7) were divided into arthroplasty (ProDisc-C, n = 7) and control (intact disc, n = 7) groups. Both groups underwent sequential posterior element resections: unilateral foraminotomy, laminoplasty, and finally laminectomy...
August 31, 2018: Journal of Neurosurgery. Spine
Ru-Sen Zhu, Shun-Li Kan, Ze-Gang Cao, Ze-Hua Jiang, Xue-Li Zhang, Wei Hu
The purpose of this meta-analysis was to explore whether cervical disc arthroplasty (CDA) was superior to anterior cervical discectomy and fusion (ACDF) in reducing secondary surgery. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Outcomes were reported as relative risk (RR) with the corresponding 95% confidence interval (CI). The pooled data was calculated using a random-effect model. We also used the trial sequential analysis (TSA) to further verify our results and obtain more moderate estimates...
August 2018: Orthopaedic Surgery
Wen-Ming Chen, Jie Jin, Taehyung Park, Kyeong-Sik Ryu, Sung-Jae Lee
BACKGROUND: Postoperative alterations in cervical spine curvature (i.e. loss of lordotic angle) are frequently observed following total disc replacement surgery. However, it remains unclear whether such changes in lordotic angle are due to preoperative spinal deformities and/or prostheses design limitations. The objective of the study is to investigate strain and segmental biomechanics of the malaligned cervical spine following total disc replacement. METHODS: Three disc prostheses were chosen, namely a metal-on-polyethylene, a metal-on-metal, and an elastomeric prosthesis, which feature different geometrical and material design characteristics...
August 10, 2018: Clinical Biomechanics
Junfeng Zeng, Hao Liu, Xin Rong, Beiyu Wang, Yi Yang, Xinlin Gao, Tingkui Wu, Ying Hong
BACKGROUND: Cervical disc arthroplasty (CDA) has been considered as an alternative to cervical arthrodesis in the treatment of cervical degenerative disc diseases (CDDD). The aim of this study was to assess the long-term clinical and radiographic outcomes of CDA with Prestige-LP Disc. METHODS: A total of 61 patients who underwent single- or two-level CDA with Prestige-LP Disc were retrospectively investigated at a minimum of 6-year follow-up. Clinical assessments included visual analogue scale (VAS) for neck and arm pain, Neck Disability Index (NDI), and Japanese Orthopedic Association (JOA) score...
August 7, 2018: BMC Musculoskeletal Disorders
Azeem Tariq Malik, Nikhil Jain, Jeffery Kim, Elizabeth Yu, Safdar N Khan
STUDY DESIGN: Retrospective review of prospective registry OBJECTIVE.: To analyze the impact of metabolic syndrome (MetS) on 30-day outcomes following elective anterior cervical discectomy and fusions (ACDFs). SUMMARY OF BACKGROUND DATA: MetS is defined as the presence of a combination of hypertension, diabetes mellitus and obesity. Past literature has reported MetS to complicate post-operative care in patients undergoing various surgical procedures, including lumbar fusions...
August 2, 2018: Spine
Anna MacDowall, Martin Skeppholm, Lars Lindhagen, Yohan Robinson, Claes Olerud
OBJECTIVE Several efforts have been made to investigate the long-term efficacy of artificial disc replacement surgery compared with that of fusion after decompression for the treatment of cervical degenerative disc disease and radiculopathy. However, research on the impact of mental distress on surgical treatment outcome has been sparse. The aim of the authors was to investigate the potential predictive value of preoperative risk factors in determining long-term outcome. METHODS A total of 153 patients (mean age 47 years) with single- or double-level cervical degenerative disc disease and radiculopathy were randomly assigned to undergo either anterior cervical discectomy and fusion (n = 70) or artificial disc replacement (n = 83)...
July 13, 2018: Journal of Neurosurgery. Spine
Miner N Ross, Donald A Ross
OBJECTIVE: Cervical spondylotic myelopathy is a common cause of neurological disability, especially in aging populations. There are several approaches to decompress the cervical spinal cord, including anterior cervical discectomy and fusion, corpectomy and fusion, arthroplasty, posterior cervical laminectomy with or without fusion, and laminoplasty. Less well described is minimally invasive cervical laminectomy. The authors report their technique and results for minimally invasive cervical laminectomy...
October 2018: Clinical Spine Surgery
My Pham, Kevin Phan, Ian Teng, Ralph J Mobbs
OBJECTIVE: Cervical spondylosis affects a huge proportion of the middle-aged population. Degenerative changes can occur in multiple regions of the cervical spine typically affecting the joints, intervertebral discs and endplates. These changes lead to compression of adjacent nervous structures, which results in radiculopathic and myelopathic pain. Various treatment modalities are currently available with non-surgical approaches the initial go to if there is no symptomatic cord compression...
May 2018: Orthopaedic Surgery
Jon Power, Nigel Loveridge, Heikki Kröger, Martyn Parker, Jonathan Reeve
OBJECTIVES: To quantitate differences between cases of hip fracture and controls in cortical width around the mid-femoral neck in men and women. METHODS: Over 5 years, 64 (14 male) participants over age 55 (mean 79) years, who had never taken bone-active drugs and suffered intra-capsular hip fracture treated by arthroplasty, donated their routinely discarded distal intra-capsular femoral neck bone for histomorphometry. After embedding, complete femoral neck cross sections from the cut surface near the narrowest part of the neck were stained with von Kossa and cortical width was measured radially every 5 degrees of arc...
September 2018: Bone
David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Simon Mazas, Louis Boissière, Ibrahim Obeid, Vincent Pointillart, Jean-Marc Vital, Olivier Gille
OBJECTIVE The objective of this study was to identify the risk factors of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and the subsequent effect of this phenomenon. METHODS The authors performed a retrospective radiological review of 185 patients with a minimum 5-year follow-up after CDA (using Bryan, Discocerv, Mobi-C, or Baguera C). Postoperative radiographs were examined and compared to the initial postoperative films to determine the percentage of ABL. The relationship of ABL to potential risk factors was analyzed...
August 2018: Journal of Neurosurgery. Spine
Xiaoyu Yang, Tessa Janssen, Mark P Arts, Wilco C Peul, Carmen L A Vleggeert-Lankamp
OBJECTIVE: The objective of this study was to review current literature on the comparison of the radiological outcome of cervical arthroplasty with fusion after anterior discectomy for radiculopathy. MATERIALS AND METHODS: A literature search was performed in PubMed, Embase, Web of Science, Cochrane, CENTRAL, and CINAHL using a sensitive search string combination. Studies were selected by predefined selection criteria (patients exclusively suffering from cervical radiculopathy), and risk of bias was assessed using a validated Cochrane checklist adjusted for this purpose...
September 2018: Spine Journal: Official Journal of the North American Spine Society
Arjun Vivek Pendharkar, Maryam Nour Shahin, Allen Lin Ho, Eric Scott Sussman, David Arnold Purger, Anand Veeravagu, John Kevin Ratliff, Atman Mukesh Desai
Spine surgery is a key target for cost reduction within the United States health care system. One possible strategy involves the transition of inpatient surgeries to the ambulatory setting. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthroplasty all represent promising candidates for outpatient surgeries in select populations. In this focused review, the authors clarify the different definitions used in studies describing outpatient spine surgery...
May 2018: Neurosurgical Focus
Ting-Kui Wu, Yang Meng, Bei-Yu Wang, Ying Hong, Xin Rong, Chen Ding, Hua Chen, Hao Liu
BACKGROUND CONTEXT: Hybrid surgery (HS), consisting of cervical disc arthroplasty (CDA) at the mobile level, along with anterior cervical discectomy and fusion at the spondylotic level, could be a promising treatment for patients with multilevel cervical degenerative disc disease (DDD). An advantage of this technique is that it uses an optimal procedure according to the status of each level. However, information is lacking regarding the influence of the relative location of the replacement and the fusion segment in vivo...
April 27, 2018: Spine Journal: Official Journal of the North American Spine Society
E Lemaire, S Ciftci, C Debry
INTRODUCTION: Dysphagia is a frequent postoperative symptom after anterior cervical disc arthroplasty. However, onset of dysphagia and neck pain a long time after surgery should suggest a diagnosis of prosthesis dislocation. CARE REPORT: A 65-year-old man with a history of cervical disc arthroplasty 27 years previously consulted for rapidly progressive dysphagia with no other associated symptoms. Physical examination and CT scan confirmed the diagnosis of anterior dislocation of the prosthesis with no signs of perforation...
August 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
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