Abstract
Introduction
Artificial cervical disc replacement [CDR] has emerged as a viable treatment alternative to fusion for the management of symptomatic compressive radiculopathy and / or myelopathy. This paper evaluates the clinical and radiological outcomes of patients treated with a second generation semi-constrained CDR with a ceramic-ceramic articulation.
Material and Methods
We conducted a prospective cohort study of all patients undergoing a cervical disc replacement for cervical disc pathology, during the period from April 2007 to April 2010 using the Discocerv ceramic disc replacement. 42 patients were available for final clinical and radiological follow-up. Both, clinical and radiological evaluation was performed at each clinical visit at 6 weeks, 6 months, 12 months and 2 years and 5 years.
Results
Three patients were lost for follow-up. C5-C6 was the commonest level. There were 34 single level cases and 8 two level cases. The NDI improved significantly (p < 0.05) from a mean preoperative score of 56% to a score of 20% at final follow-up. The mean preoperative mobility at the index level unit was 12.2 ± 4.5°, this decreased to 7.9 ± 3.2° at six weeks, but slightly increased to 12.9 ± 2.9° at 1 year (gain not significant). Heterotrophic ossification [HO] was noted in 10 [23%] patients.
Conclusion
Based on our study of cervical disc replacement with a ceramic-ceramic bearing surface, this appears to be a viable option in the treatment of variety of cervical pathologies. This ceramic-ceramic interface eliminates potential problems like metallosis but further longer-term results should be reported.