General Session: Arthroplasty - Hall F

Presented by: P. Pazmino

Author(s):

P. Pazmino(1), R. Husman(2), G. Margossian(3)

(1) SpineCal, Santa Monica, CA, United States
(2) UCLA, Los Angeles, CA, United States
(3) SpineCal, Glendale, CA, United States

Abstract

Considerable subsets of patients demonstrate multiple level symptomatic cervical discogenic disease. In efforts to preserve motion and limit force concentrations at the remaining segments, cervical hybrid disc arthroplasty has gained momentum as a new treatment modality. To our knowledge there are no clinical studies, which evaluate the outcomes of patients with cervical hybrid disc arthroplasty. The present study evaluates our subset of patients through their patient perceived outcomes, return to sport, return to sexual activity, and their return to work. A total of 153 discs in 153 patients were reviewed. We performed hybrid disc arthroplasty using the Prodisc-C prosthesis in concert with fusion constructs. Outcome variables included radiographic fusion and clinical assessment using visual analog scale for neck pain, visual analog scale for arm pain, and the Neck disability instruments. 153 patients, 83 males and 70 females were treated with a cervical hybrid construct. Mean patient age was 43.69 years, mean duration of pain before surgery was 8.39 months, and mean follow up was 66 months. All patients were available at each follow-up interval. Clinical results were evaluated by assessing preoperative and postoperative imaging, axial neck pain, radiculopathy, disability, and lifestyle outcomes analysis. Patients demonstrated statistically significant improvement in NDI and VAS scores at all follow-up periods compared to baseline (P < 0.05). There was improvement in VAS score for neck pain (P < .005), radicular arm pain (P < .006), and NDI score (P < .06) after surgery, with 85%, 88%, and 73% of patients showing improvement in their VAS neck pain, VAS arm pain, and NDI scores, respectively. The mean interval from surgery to return to sports was 1.8 months or 56 days (range 33-71). The mean interval from surgery to return to work for the 102 patients in employment was 29 days (range 3-38). The mean interval to return to sexual activity for the 92 patients in relationships was 26 days (range 16-38). Cervical hybrid arthroplasty appears to be a safe and effective treatment for painful cervical discogenic disease. The hybrid procedure is a viable option in properly selected patients and this group demonstrates rapid improvement, return to functional status, sexual activity, work and sport, which are achieved within several months.