Abstract
Introduction
Cervical disc arthroplasty has been shown to be as effective as fusion in radiculopathy in appropriately selected patients. Discocerv(Alphatec Spine, Carlsbad, USA) was introduced to reduce the difficulty of end plate preparation. Aim of this study is to evaluate the early results of clinical and radiographic outcome in patients implanted with Discocerv, which is semiconstrained mobile prosthesis made of ceramic bearings.
Material and Methods
From December 2008 to June 2012, 14 patients were enrolled in this retrospective study. They all suffered from single level radiculopathy due to acute disc rupture, and underwent total disc replacement with Discocerv. The mean follow-up period was 28 months (12~60 months). There were 8 males and 6 females and the mean age was 46.9 years old (39–66). The clinical outcomes were analyzed by using preoperative and postoperative follow up Korean version of neck disability index(K-NDI) and visual analogue scale(VAS). Also segmental motion was assessed by using dynamic flexion –extension lateral view, and heterotopic ossification or other complications were assessed.
Results
The mean VAS score improved significantly from 8 preoperatively to 0.3, 0.6 at one year, two years respectively and mean NDI score also improved from 28 preoperatively to 9, 6.4, 8.75 at three months, one year, two years respectively after operation. The mean segmental motion was 3.2 degree preoperatively and 4.7, 4.6, 6.6 degree at postoperative six months, one year, two years respectively and after 3 years, mean segmental motion decreased to 3.1 degree and to 1.9 degree at four years. Heterotrophic ossification was not detected in all cases, but anterior osteophyte formation at implanted segment was seen in 3 cases after three years. There was no radiologic complication related to wear. But 2 patients complained subjective discomfort as if they felt friction sound of their artificial joint.
Conclusion
Single level cervical arthorplasty with Discocerv showed good clinical outcomes and motion preservation sustained up to postoperative 3 years. Also, there were no major complications or no heterotopic ossification. However, 14% of patients felt friction sound by themselves.