Artikel
Cervical disc prosthesis: the effect of rigorous indication on clinical outcome
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Autoren
Veröffentlicht: | 13. Juni 2005 |
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Gliederung
Text
Introduction
Cervical total disc replacement is assumed to avoid the increase of intradiscal pressure in the adjacent segment. In two centers participating in the Prodisc-C European Multicenter Study different ranges of indication were set. Center A: single level procedure in patients with radiculopathy Center B) single/multilevel procedures in patients affected by radiculo/myelopathy. The surgical impact on pain intensity and Neck disability index (NDI) postoperatively and six months after surgery are reported.
Methods
(A) 15 patients (8 females, mean age 42 years, 15 implants) corresponding to 22% of all patients admitted for anterior cervical surgery. (B) 32 patients (18 females, mean age 49 years, 42 implants) corresponding to 44% of all patients requiring anterior cervical surgery. Pain intensity (VAS) and Neck disability index (NDI) was assessed by an independent observer.
Results
Before surgery: (A): VAS 7.3 (neck), VAS 4 (arm), NDI 55%; (B): VAS 4,5 (neck), VAS 5,8 (arm), NDI 38%. Six weeks after surgery: (A) VAS 1 (neck and arm), NDI 15 %; (B): VAS 2.2 (neck), VAS 2.0 (arm), NDI 22 %. Six months after surgery: (A): VAS 0 (neck and arm), NDI 7%; (B): VAS 2.1 (neck), Vas 1.5 (arm), NDI 21%.
Conclusion
The preliminary results show that favourable prognostic factors for cervical arthroplasty are: age < 50 years, single level disc herniation causing radiculopathy, intact lordotic curvature of the C-spine and absence of spondylotic spurs at the adjacent segments.