315 - Prestige Cervical Artificial Disc Replacement: Long Term Follow up...

#315 Prestige Cervical Artificial Disc Replacement: Long Term Follow up

Cervical Therapies and Outcomes

Poster Presented by: K. Pettine

Author(s):

K.A. Pettine (1)

(1) The Spine Institute, Loveland, CO, USA

Abstract

Purpose: This abstract represents the first prospective class II data available from a non-IDE site on the clinical results of one- and two-level Prestige at up to three-year follow-up.

Materials and Methods: Every patient was evaluated pre-operatively with flexion/extension radiographs, MRI scanning, physical examination and evaluation of neck disability index (NDI) and VAS. Follow-up occurred at six weeks, three months, six months, one year, two years and three years post op. There were 136 patients who underwent a one-level Prestige cervical artificial disc replacement. The average age was 45 years and the average BMI was 27.2. There were 65 males and 71 females. The average operative time was 54.1 minutes. The average pre-operative NDI was 57.4 which improved to 37.8 at one year (p< 0.0001), 35.4 at two years (p< 0.0001) and 41.6 at three years (p< 0.0031). The average pre-operative VAS was 7 which improved to 4 at one year (p< 0.0001), 4 at two years (p< 0.0001) and 3.8 at three years (p< 0.0001). There was one revision to an anterior cervical fusion and one redo nerve root decompression.

There were 55 patients who underwent a two-level Prestige artificial disc replacement. The average age was 48 years and the average BMI was 28.1. The average operative time was 83.6 minutes. The average pre-operative NDI was 59.0 which improved to 31.6 at one year (p< 0.0001), 39.6 at two years (p< 0.0012) and 35.6 at three years (p< 0.003). The average pre-operative VAS was 7 which improved to 2.8 at one year (p< 0.0001), 3.2 at two years (p< 0.0001) and 2.9 at three years (p< 0.0001). There were no revisions or reoperations in this group. Every patient in this series left the surgical facility within 24 hours of their surgery.

Conclusions: A previous metanalysis of over 1,000 patients following single-level anterior cervical fusion class I data indicates a revision rate of 10% at two years and a clinical success rate of 70%. These results of the one- and two-level Prestige surgeries indicate superior clinical results and a revision reoperation rate of 1%. These results indicate one- and two-level Prestige cervical artificial disc replacements can safely be performed at ambulatory surgery center with efficacy. The clinical results are superior to those reported with class I data concerning one-level anterior cervical fusion with a significantly lower reoperation rate.