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Prognostic factors related to motion dynamics following cervical arthroplasty with a bryan disc: average 2-year follow-up.

Ryu KS, Heo HY, Lee SJ, Lee KY, Park CK - SAS J (2008)

Bottom Line: At upper and lower segments, ROMs did not change significantly postoperatively.No significant relationships were found between VAS and NDI improvement and changes in ROMs or segmental angles at last follow-up.These factors however do not relate to the clinical outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Kang Nam St. Mary's Hospital, Catholic University, Seoul, Korea.

ABSTRACT

Background: This is a retrospective study to assess the prognostic factors influencing the postoperative motion dynamics and clinical outcome following cervical arthroplasty with a Bryan disc.

Methods: Twenty-seven patients (30 levels) consecutively underwent cervical arthroplasty using a Bryan disc (Medtronic Sofamor Danek, Memphis, Tennessee). Motion dynamics and clinical outcome (visual analogue score (VAS) and neck disability index (NDI) score) were examined preoperatively and at 1 month, 1 year, and final follow-up (average: 25 months). The prognostic factors influencing clinical outcome and postoperative motion dynamics were assessed.

Results: At last follow-up, mean VAS and NDI scores were significantly decreased from 8.33 ± 1.52 to 1.10 ± 0.99 (P = .001) and from 25.0 ± 15.9 to 9.2 ± 5.9 (P = .001), respectively. In a comparative study of pre- and postoperative motion changes at operated segments, mean segmental range of motion (ROM) increased from 6.96° ± 2.03° to 8.93° ± 3.53° (P = .014), and mean segmental angle decreased from 2.85° ± 3.27° to 1.21° ± 5.93° (P = .126). Mean global angle increased significantly from 14.54° ± 10.32° to 18.36° ± 11.10° (P = .003), and ROM increased non-significantly from 40.25° ± 13.51° to 41.56° ± 12.53° (P = .654). At upper and lower segments, ROMs did not change significantly postoperatively. The heights of functional segment units showed no change postoperatively (3.51 ± 0.21 to 3.49 ± 0.22, P = .701). No significant relationships were found between VAS and NDI improvement and changes in ROMs or segmental angles at last follow-up. Statistically, the postoperative functional segment unit (FSU) ROM decreased as the age of the patients increased (Spearman r = 0.391, P = .048). The gender and preoperative segmental ROM did not influence FSU ROM.

Conclusions: Our results demonstrate that cervical arthroplasty with the Bryan disc for the treatment of cervical degenerative provides a good clinical outcome and preserves motion postoperatively. The age of the patients and the preoperative segmental ROM significantly affect the postoperative FSU ROM. These factors however do not relate to the clinical outcome. The relationship between long-term outcome and these variables should be verified by a larger cohort study.

No MeSH data available.


Radiograph showing the method of FSU height measurement. Both anterior and posterior FSU heights were measured pre- and postoperatively. The A and B represent the anterior and posterior heights between the superior endplate of the rostral vertebra and the lower endplate of the caudal endplate, respectively. Film magnification was adjusted into the value which was obtained by the length of the inferior endplate of the caudal vertebra into the sum of the value A and B (A+B / C).
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Figure 0001: Radiograph showing the method of FSU height measurement. Both anterior and posterior FSU heights were measured pre- and postoperatively. The A and B represent the anterior and posterior heights between the superior endplate of the rostral vertebra and the lower endplate of the caudal endplate, respectively. Film magnification was adjusted into the value which was obtained by the length of the inferior endplate of the caudal vertebra into the sum of the value A and B (A+B / C).

Mentions: Radiographic images were obtained for all patients preoperatively, at 1 month and 1 year postoperatively, and at final follow-up. Images obtained at each time point consisted of anteroposterior (AP), lateral, flexion, and extension films. Detailed radiographic assessments were performed on digital radiograph images displayed on a PACS (Picture Achieve and Communication System) terminal (Marosis 2003, Marotech, Seoul), and angles were measured using a program in PACS. Angles of functional segment units (FSUs), global angles (from the lower endplate of C2 to the inferior endplate of C7), and adjacent segment angles were measured. Flexion- extension segmental ROM was measured at all affected and adjacent levels. ROMs were determined from differences between flexion and extension angles. Global ROMs and FSU heights (Figure 1) were also measured.


Prognostic factors related to motion dynamics following cervical arthroplasty with a bryan disc: average 2-year follow-up.

Ryu KS, Heo HY, Lee SJ, Lee KY, Park CK - SAS J (2008)

Radiograph showing the method of FSU height measurement. Both anterior and posterior FSU heights were measured pre- and postoperatively. The A and B represent the anterior and posterior heights between the superior endplate of the rostral vertebra and the lower endplate of the caudal endplate, respectively. Film magnification was adjusted into the value which was obtained by the length of the inferior endplate of the caudal vertebra into the sum of the value A and B (A+B / C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4365825&req=5

Figure 0001: Radiograph showing the method of FSU height measurement. Both anterior and posterior FSU heights were measured pre- and postoperatively. The A and B represent the anterior and posterior heights between the superior endplate of the rostral vertebra and the lower endplate of the caudal endplate, respectively. Film magnification was adjusted into the value which was obtained by the length of the inferior endplate of the caudal vertebra into the sum of the value A and B (A+B / C).
Mentions: Radiographic images were obtained for all patients preoperatively, at 1 month and 1 year postoperatively, and at final follow-up. Images obtained at each time point consisted of anteroposterior (AP), lateral, flexion, and extension films. Detailed radiographic assessments were performed on digital radiograph images displayed on a PACS (Picture Achieve and Communication System) terminal (Marosis 2003, Marotech, Seoul), and angles were measured using a program in PACS. Angles of functional segment units (FSUs), global angles (from the lower endplate of C2 to the inferior endplate of C7), and adjacent segment angles were measured. Flexion- extension segmental ROM was measured at all affected and adjacent levels. ROMs were determined from differences between flexion and extension angles. Global ROMs and FSU heights (Figure 1) were also measured.

Bottom Line: At upper and lower segments, ROMs did not change significantly postoperatively.No significant relationships were found between VAS and NDI improvement and changes in ROMs or segmental angles at last follow-up.These factors however do not relate to the clinical outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Kang Nam St. Mary's Hospital, Catholic University, Seoul, Korea.

ABSTRACT

Background: This is a retrospective study to assess the prognostic factors influencing the postoperative motion dynamics and clinical outcome following cervical arthroplasty with a Bryan disc.

Methods: Twenty-seven patients (30 levels) consecutively underwent cervical arthroplasty using a Bryan disc (Medtronic Sofamor Danek, Memphis, Tennessee). Motion dynamics and clinical outcome (visual analogue score (VAS) and neck disability index (NDI) score) were examined preoperatively and at 1 month, 1 year, and final follow-up (average: 25 months). The prognostic factors influencing clinical outcome and postoperative motion dynamics were assessed.

Results: At last follow-up, mean VAS and NDI scores were significantly decreased from 8.33 ± 1.52 to 1.10 ± 0.99 (P = .001) and from 25.0 ± 15.9 to 9.2 ± 5.9 (P = .001), respectively. In a comparative study of pre- and postoperative motion changes at operated segments, mean segmental range of motion (ROM) increased from 6.96° ± 2.03° to 8.93° ± 3.53° (P = .014), and mean segmental angle decreased from 2.85° ± 3.27° to 1.21° ± 5.93° (P = .126). Mean global angle increased significantly from 14.54° ± 10.32° to 18.36° ± 11.10° (P = .003), and ROM increased non-significantly from 40.25° ± 13.51° to 41.56° ± 12.53° (P = .654). At upper and lower segments, ROMs did not change significantly postoperatively. The heights of functional segment units showed no change postoperatively (3.51 ± 0.21 to 3.49 ± 0.22, P = .701). No significant relationships were found between VAS and NDI improvement and changes in ROMs or segmental angles at last follow-up. Statistically, the postoperative functional segment unit (FSU) ROM decreased as the age of the patients increased (Spearman r = 0.391, P = .048). The gender and preoperative segmental ROM did not influence FSU ROM.

Conclusions: Our results demonstrate that cervical arthroplasty with the Bryan disc for the treatment of cervical degenerative provides a good clinical outcome and preserves motion postoperatively. The age of the patients and the preoperative segmental ROM significantly affect the postoperative FSU ROM. These factors however do not relate to the clinical outcome. The relationship between long-term outcome and these variables should be verified by a larger cohort study.

No MeSH data available.