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Cervical disk degeneration

Timothy T Roberts, Ryan J Filler, Jason W Savage, Edward C Benzel
In the United States, cervical total disk arthroplasty (TDA) is US Federal Drug Administration (FDA) approved for use in both 1 and 2-level constructions for cervical disk disease resulting in myelopathy and/or radiculopathy. TDA designs vary in form, function, material composition, and even performance in vivo. However, the therapeutic goals are the same: to remove the painful degenerative/damaged elements of the intervertebral discoligamenous joint complex, to preserve or restore the natural range of spinal motion, and to mitigate stresses on adjacent spinal segments, thereby theoretically limiting adjacent segment disease (ASDis)...
January 8, 2018: Clinical Spine Surgery
Kittipong Sessumpun, Permsak Paholpak, Kevork N Hindoyan, Koji Tamai, Thananit Sangkomkamhang, Zorica Buser, Jeffrey C Wang
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate how each type of sagittal cervical alignment affects the motion of the upper and subaxial cervical spine using kinematic magnetic resonance imaging. SUMMARY OF BACKGROUND DATA: The sagittal malalignment of the cervical spine from degeneration in the subaxial cervical spine reflects a disruption in the kinematic properties of the cervical spine and affects the motion of adjacent segments...
January 8, 2018: Clinical Spine Surgery
Bolong Zheng, Dingjun Hao, Hua Guo, Baorong He
BACKGROUND: ACDF has been considered as the gold standard in the treatment of single level cervical disk protrusion. However, it may cause adjacent level degeneration due to regional biomechanical changes. TDR has been applied with satisfactory results for over a decade, but there is no consensus if TDR is safer and more efficient than ACDF. The current study was carried out to compare the efficiency and safety of TDR and ACDF in the treatment of patients with single level cervical disk protrusion...
November 28, 2017: BMC Surgery
Li-Shan Huang, Ping-Ping Huang, Xiu-Bing Tong, Zhong-Li Li, Yan-Ping Fang, Jun Liao
OBJECTIVE: To observe the effect of chiropractics on intervertebral disk extracell matrix metalloproteinase (MMP)-1, MMP-3, MMP-13, cellular collagen type Ⅱ (COL-Ⅱ), tissue inhibitor 1 of metalloproteinase (TIMP-1) and extracellular matrix (ECM) in the rats with cervical spondylosis, so as to explore its mechanism underlying improvement of cervical spondylosis. METHODS: A total of 40 SD rats were randomized into a sham group, a model group, a chiropractics group and a mobic group, 8 rats in each one...
August 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
Liang Dong, Dongqi Wang, Xiujin Chen, Tuanjing Liu, Zhengwei Xu, Mingsheng Tan, Dingjun Hao
STUDY DESIGN: This is a meta-analysis of controlled trials. OBJECTIVE: To assess the overall condition of adjacent segment of cervical disk arthroplasty (CDA) compared with anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: With the increase in CDA and ACDF, surgeons are taking more attention to adjacent segment degeneration (ASDeg) and adjacent segment disease (ASDis). There are more and more meta-analyses comparing the efficacy of CDA with ACDF, however, there are few meta-analyses referring to adjacent segment parameters, and investigators are still unable to arrive at the same conclusion...
June 15, 2017: Clinical Spine Surgery
Roland D Donk, Wim I M Verhagen, Allard J F Hosman, Andre Verbeek, Ronald H M A Bartels
STUDY DESIGN: A prospective cohort of 142 patients underwent either anterior cervical discectomy alone, anterior cervical discectomy with fusion by cage stand-alone, or anterior cervical discectomy with arthroplasty. We then followed up on their condition for a mean of 9.1±1.9 years (5.6-12.2 y) later. OBJECTIVE: We aimed to evaluate the annual rate of clinically symptomatic adjacent segment disease (ASD) and to analyze predictive factors. SUMMARY OF BACKGROUND DATA: Until recent, ASD has been predominantly evaluated radiologically...
June 9, 2017: Clinical Spine Surgery
Sheng Bin, Huang Xiangwang, Xiao Sheng, Xiang Tiecheng, Liu Xiangyang, Zhang Yi, Liu Bin
STUDY DESIGN: Retrospective study. OBJECTIVE: To evaluate the outcome of artificial cervical disk replacement (ACDR) for the treatment of adjacent segment disease (ASD) after anterior cervical decompression and fusion (ACDF). SUMMARY OF BACKGROUND DATA: ACDF is the useful procedure for degenerative cervical diseases. However, studies have reported accelerated degeneration of functional spinal units adjacent to the fusion site after ACDF. MATERIALS AND METHODS: Between January 2004 and January 2011, 32 inpatients (18 male, 14 female; age, 38-61 y; mean, 48 y) underwent ACDR for the treatment of ASD after previous ACDF (single-level: n=12; 2-level: n=15; 3-level: n=5)...
June 2017: Clinical Spine Surgery
Wei Tian, Kai Yan, Xiao Han, Jie Yu, Peihao Jin, Xiaoguang Han
STUDY DESIGN: Prospective nonrandomized comparative study. OBJECTIVE: To compare the long-term clinical and radiographic results of cervical artificial disk replacement (CADR) and anterior cervical discectomy and fusion (ACDF), and to provide our evidence if CADR could reduce adjacent segment degeneration (ASD). SUMMARY OF BACKGROUND DATA: CADR is widely used in spine surgery today. Despite the short-term results of it having been ascertained, the long-term results are still under observation...
June 2017: Clinical Spine Surgery
Akinobu Suzuki, Michael D Daubs, Tetsuo Hayashi, Monchai Ruangchainikom, Chenjie Xiong, Kevin Phan, Trevor P Scott, Jeffery C Wang
STUDY DESIGN: Retrospective analysis of kinetic magnetic resonance images (kMRIs). OBJECTIVE: (1) To analyze the changes seen on MRI related to disk degeneration and to develop a new grading system for cervical disk degeneration. (2) To evaluate the reliability and validity of the grading system. SUMMARY OF BACKGROUND DATA: Few have studied the relationship between changes seen on MRI with cervical disk degeneration and the chronological order of disk degeneration...
June 2017: Clinical Spine Surgery
Nam-Su Chung, Chang-Hoon Jeon, Yu-Sang Lee, Jang-Ho Park, Han-Dong Lee
STUDY DESIGN: This is a retrospective control study. OBJECTIVE: We aimed to determine whether preexisting cervical disk degeneration is a prognostic factor in Whiplash-associated disorder (WAD). SUMMARY OF BACKGROUND DATA: WAD is a common injury of traffic accident and has a broad range of prognoses. Although numerous studies have investigated prognostic factors in WAD, few have evaluated the effect of preexisting disk degeneration. MATERIALS AND METHODS: This study involved 45 consecutive patients with grade I or II WAD having advanced disk degeneration (at least 1 disk of Miyazaki grade≥III on magnetic resonance imaging) and a control cohort of 52 patients with no or mild disk degeneration (all disks having Miyazaki grades≤II)...
November 2017: Clinical Spine Surgery
Yu Ding, Di-Ke Ruan, Qing He, Li Sheng Hou, Jian Ning Lin, Hong Peng Cui
STUDY DESIGN: The clinical and radiologic data of total disk allografting (TDA) cases were collected and analyzed to explore the correlation between neurological function improvements and imaging changes. OBJECTIVE: The aim of the study was to assess the medium-term and long-term outcome and radiographic character after TDA, and, furthermore, to explore the significance of the changes of imaging signs after the transplantation. SUMMARY OF BACKGROUND DATA: Spinal fusion may result in the adjacent segment degeneration...
November 2016: Clinical Spine Surgery
Lei Kuang, Yuqiao Chen, Bing Wang, Lei Li, Guohua Lü
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To assess the safety and efficacy of cervical disk arthroplasty (CDA) compared with anterior cervical decompression and fusion (ACDF) for the treatment of 2-level cervical spondylopathy. SUMMARY OF BACKGROUND DATA: CDA has emerged as a potential alternative to ACDF in patients with cervical disk degeneration. But there are no published systematic reviews and meta-analyses comparing CDA with ACDF for the treatment of 2-level cervical spondylopathy...
November 2016: Clinical Spine Surgery
Kris Siemionow, Piotr Janusz, Frank M Phillips, Jim A Youssef, Robert Isaacs, Marcin Tyrakowski, Bruce McCormack
Background Indirect posterior cervical nerve root decompression and fusion performed by placing bilateral posterior cervical cages in the facet joints from a posterior approach has been proposed as an option to treat select patients with cervical radiculopathy. The purpose of this study was to report 2-year clinical and radiologic results of this treatment method. Methods Patients who failed nonsurgical management for single-level cervical radiculopathy were recruited. Surgical treatment involved a posterior approach with decortication of the lateral mass and facet joint at the treated level followed by placement of the DTRAX Expandable Cage (Providence Medical Technology, Lafayette, California, United States) into both facet joints...
November 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Jianfeng Zhang, Fanxin Meng, Yan Ding, Jie Li, Jian Han, Xintao Zhang, Wei Dong
To investigate the outcomes and reliability of hybrid surgery (HS) versus anterior cervical discectomy and fusion (ACDF) for the treatment of multilevel cervical spondylosis and disc diseases.Hybrid surgery, combining cervical disc arthroplasty (CDA) with fusion, is a novel treatment to multilevel cervical degenerated disc disease in recent years. However, the effect and reliability of HS are still unclear compared with ACDF.To investigate the studies of HS versus ACDF in patients with multilevel cervical disease, electronic databases (Medline, Embase, Pubmed, Cochrane library, and Cochrane Central Register of Controlled Trials) were searched...
May 2016: Medicine (Baltimore)
Martin Dostal, Denis Laurent Kaech
Background Anterior cervical diskectomy (ACD) is an established therapy for degenerative cervical radiculopathy and myelopathy. Controversy remains regarding the dynamic or rigid stabilization of the segment. Methods We studied our first 31 patients treated with ACD plus the Dynamic Cervical Implant (DCI) as an alternative to fusion or to arthroplasty, treated between February 2009 and 2011. Radiologic data were collected before and 12 months after surgery. Clinical results were documented 12 months after surgery...
November 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Yijie Liu, Heng Wang, Xuefeng Li, Jie Chen, Han Sun, Genlin Wang, Huilin Yang, Weimin Jiang
PURPOSE: We aimed to analyze the clinical and radiographic efficacy of a new zero-profile anchored spacer called the ROI-C in anterior discectomy and fusion (ACDF) for multilevel cervical spondylotic myelopathy (MCSM). METHOD: We retrospectively reviewed the clinical, radiological outcomes and complications of multilevel ACDF with the ROI-C or with the polyetheretherketone (PEEK) cages with an anterior plate. From April 2011 to April 2014, 60 patients with MCSM were operated on using ACDF, with the ROI-C in 28 patients and PEEK cages with an anterior plate in 32 patients...
June 2016: European Spine Journal
Cheng Zeng, Jian Xiong, Jeffrey C Wang, Hirokazu Inoue, Yanlin Tan, Haijun Tian, Bayan Aghdasi
Study Design Retrospective cohort study. Objective The objective was to measure the change of flavum ligament diameter during positional changes of the cervical spine using kinetic magnetic resonance imaging (MRI) and to examine the correlational diameter changes of the flavum ligament, disk bulging, and the spinal canal from extension to flexion positions. Methods One hundred eight-nine patients underwent kinetic MRI in neutral, extension, and flexion positions. The diameters of cervical ligamentum flavum, disk bulging, and cervical spinal canal and the disk degeneration grade and Cobb angles were measured from C2-C3 to C7-T1...
March 2016: Global Spine Journal
Sun Qizhi, Sun Lei, Li Peijia, Zhao Hanping, Hu Hongwei, Chen Junsheng, Li Jianmin
STUDY DESIGN: A prospective randomized and controlled study of 30 patients with 2 noncontiguous levels of cervical spondylosis. OBJECTIVE: To compare the clinical outcome between zero-profile devices and artificial cervical disks for noncontiguous cervical spondylosis. SUMMARY OF BACKGROUND DATA: Noncontiguous cervical spondylosis is an especial degenerative disease of the cervical spine. Some controversy exists over the choice of surgical procedure and fusion levels for it because of the viewpoint that the stress at levels adjacent to a fusion mass will increase...
March 2016: Clinical Spine Surgery
Hironobu Sakaura, Toshitada Miwa, Yusuke Kuroda, Tetsuo Ohwada
Study Design Retrospective study. Objective We previously reported that the long-term neurologic outcomes of C3-C6 laminoplasty for cervical spondylotic myelopathy (CSM) are satisfactory, with reduced frequencies of postoperative axial neck pain and kyphotic deformity. However, only 20 patients were included, which is a limitation in that study. The present study investigated the incidence of late neurologic deterioration (LND) of myelopathic symptoms after C3-C6 laminoplasty for CSM and attempted to identify significant risk factors for LND in a larger patient population...
February 2016: Global Spine Journal
Wenjie Wu, Jingtong Lyu, Hao Liu, Xin Rong, Beiyu Wang, Ying Hong, Quan Gong, Tao Li, Limin Liu, Yueming Song, Yong Cai, Wenli Xu
Surgical treatment is one of the effective methods of treatment in cervical spondylosis. The traditional method of operation is decompression fusion; however, this surgery results in restricted movement of cervical vertebra and adjacent segment degeneration. Due to the deficiency of traditional surgery, scholars have widely carried out artificial cervical disk replacement surgery and have achieved good clinical effects. Comparing to the characteristics of the common artificial cervical disk which is used frequently, we developed a new artificial cervical intervertebral disk prosthesis...
September 2015: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
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