Radiologic and Clinical Evaluation 12 Months after Anterior Cervical Diskectomy and Dynamic Stabilization of the Segment with Dynamic Cervical Implant

J Neurol Surg A Cent Eur Neurosurg. 2016 Nov;77(6):474-481. doi: 10.1055/s-0035-1571164. Epub 2016 Mar 29.

Abstract

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. The radiologic analysis focused on the mobility of the segment, position of the implant, amount of preoperative osteochondrosis, and the development of heterotopic ossifications (HOs) after 1 year. Results At the 1-year follow-up after DCI implantation, there was quite a high fusion rate (23%); however, the formation of HOs was comparable with that of arthroplasty. Fusion could not be predicted by viewing the degree of disk degeneration on preoperative magnetic resonance imaging studies and had no negative impact on the clinical outcome. Conclusion As an alternative to arthroplasty, DCI does maintain some flexion-extension mobility after 1 year in 77% of our cases.

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Diskectomy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration / diagnostic imaging
  • Intervertebral Disc Degeneration / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Radiography
  • Range of Motion, Articular
  • Spinal Fusion / methods*
  • Total Disc Replacement / methods*
  • Treatment Outcome