215 - Prospective Clinical Results of 1 Level Cervical Arthroplasty with the...

#215 Prospective Clinical Results of 1 Level Cervical Arthroplasty with the Prestige Device: Four Year Results

Oral Posters: Cervical Arthroplasty

Presented by: A. Fabrizi

Author(s):

A.P. Fabrizi (1), (2)
L. Schiabello (1), (2)

(1) Villa Maria Pia Hospital, Neurosurgery, Turin, Italy
(2) San Pier Damiano Hospital, Neurosurgery, Faenza, Italy

Abstract

Introduction: The rate of symptomatic adjacent cervical level that may occur after Anterior Cervical Discectomy and Fusion (ACDF) is up to 30% is concerning. The cervical disc replacement provides an option for the treatment of radiculopathy and myelopathy degenerative anterior cervical spine, while it may prove to provide an impact on the development of adjacent segment disease.

Purpose: To check the preliminary results about efficacy and safety of the Prestige cervical replacement.

Methods: This is a prospective study of 100 patients with cervical arthroplasty at two institutions with the Prestige device for 1 disc level. There were 82 sole implants and 18 associated with other ACDF. Follow-up is up to 4 years now, and the results are reported in terms of Visual Analog Scale (VAS) for pain, VAS for patient satisfaction, and flexion-extension range of motion.

Results: Improvements in neuropathy, pain, and patient satisfaction is noted in 90% of patients. There is a trend to increased benefit in cases with multi-level fusion, which correlates to increased preoperative disability. At the mean 36 month follow-up imaging all patients had solid bone fusions that embedded the device. There was signs of heterotopic ossification in 8 patients and no patient experienced migration of the cervical replacement. There have been no re-operations for continued pain. Only in 4 patients adjacent segment problems have been detected at final follow up imaging.

Conclusion: Cervical disc replacement had good clinical results as measured by preoperative and postoperative VAS. Radiographic study suggested normal motion at implanted site and restrictive postoperative management is not required. In our opinion, Prestige cervical disc replacement is a stable implant in reconstructing cervical spine after anterior discectomy. This study represents the largest number and longest follow-up of single level cervical disc replacement in Italy. Final effectiveness will be determined after long-term follow-up studies.