期刊论文详细信息
BMC Musculoskeletal Disorders
Clinical and radiographic outcome of dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc disease: a minimal five-year follow-up
Yue-ming Song1  Xi Yang1  Lei Wang1  Lin-nan Wang1  Li-min Liu1  Bo-wen Hu1  Hao Liu1 
[1] Department of Orthopedics, West China Hospital, Sichuan University;
关键词: Dynamic cervical implant;    Degenerative cervical disc disease;    Heterotopic ossification;    Anterior migration;    Subsidence;   
DOI  :  10.1186/s12891-018-2017-7
来源: DOAJ
【 摘 要 】

Abstract Background To evaluate the mid- to long-term clinical and radiographic outcomes of anterior cervical discectomy and dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc disease. Methods From April 2010 to October 2010, 38 patients with single- or double-level cervical disc herniation underwent anterior cervical discectomy and DCI arthroplasty. The clinical results and radiographic outcomes of these 38 patients (42 levels) were retrospectively evaluated. The clinical results included the visual analogue scale, Japanese Orthopaedic Association score, Neck Disability Index score, 36-item short form health survey questionnaire, and incidences of complications and neurological deterioration. Radiographic results including cervical alignment, intervertebral height, cervical range of motion (ROM), ROM of the functional spinal unit, adjacent intervertebral ROM, migration, subsidence, and heterotopic ossification (HO) were assessed on plain radiography, three-dimensional computed tomography, and magnetic resonance imaging. Results The mean follow-up period was 72.3 months (range 68–78 months). During follow-up, all patients showed significant improvements in the visual analogue scale score, Japanese Orthopaedic Association score, Neck Disability Index score, 36-item short form health survey physical component summary score and mental component summary score. The ROM of the functional spinal unit was partly reduced. The DCI migrated forward in 10 of 42 (23.8%) cases, and HO was detected in 24 of the 42 (57.1%) DCI segments. Subsidence was observed in 14 of 42 (33.3%) DCI segments. Two patients experienced symptom recurrence, and were treated conservatively. Conclusions The clinical efficacy of DCI arthroplasty was maintained during mid- to long-term follow-up. HO formation is a common phenomenon, leading to a substantial decrease in ROM at the index level and recurrence of neurological symptoms. The incidence of implant subsidence and migration is relatively high, leaving a potential risk of symptoms at the index level and adjacent segment degeneration. We consider that the first choice for patients with degenerative cervical disc disease should still be total disc replacement or anterior cervical discectomy and fusion, rather than DCI arthroplasty.

【 授权许可】

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