#285 Lessons Learned on Cervical Total Disc Replacement after 8 Years Follow-up
Cervical Therapies and Outcomes
Poster Presented by: L. Pimenta
L. Pimenta (1), (2)
R. Jensen (1)
L. Marchi (1)
L. Oliveira (1)
C. Castro (1)
E. Coutinho (1)
T. Coutinho (1)
R. Amaral (1)
(1) Instituto de Patologia da Coluna, Sao Paulo, Brazil
(2) UCSD, Neurosurgery, San Diego, CA, USA
Purpose: Various studies demonstrate that single-level ACDF procedures do alter spinal kinematics and multilevel procedures compromise global spinal motion. Arthroplasty technology was developed to maintain movement and reduce adjacent segment stress and degeneration. Here we show our 8 years experience with PCM total disc replacement.
Methods: We studied radiographs of 270 levels in 158 patients treated with cervical TDR using the PCM device between C3-4 and C7-T1. Radiological and clinical outcomes were collected preoperatively, 1 week and 1, 3 and 6 months and annually.
Results: Using the four grade classification, the majority of patients belong to grade I and II. We didn't find relationship between the CT scan facet degeneration and clinical results in these stages, except in grade III and IV that outcomes scales had a worsening. 21(7.7%) revealed some level of HO. Of these, 10 levels were rated to be grade I (47.6%),7 to be grade II (33.3%), 3 to be grade III (14.28%) and 1 to be grade IV (4.76%).The affected disc level was part of a multi-level procedure in 41.6%, and 58.4% in a single level construction. In 92% of patients that developed HO, preoperative radiographs showed incipient osteophytes. Painful adjacent level disease occurred in 5.7% of patients.
Conclusion: Our experience in cervical TDR has reveled valuable clinical and radiological data when compared to ACDF. The good clinical results also corroborate with the superiority of cervical TDR in comparison to ACDF results described on the literature.