The aim of this study was to evaluate the long-term clinical and radiographic outcomes of cervical arthroplasty using the ProDisc-C prosthesis.
Clinical and radiographic evaluations, including dynamic flexion–extension lateral images, were performed at baseline and at 10-year follow-up.
Twenty-seven patients who had single-level ProDisc-C arthroplasty were followed up for a mean period of 123 months. The range of motion at the operated level was 8.9° ± 3.9° at baseline and 6.6° ± 3.5° at final follow-up. Twenty of 27 levels (74%) developed heterotopic ossification. According to McAfee’s classification, one level was classified as grade I, four levels were classified as grade II, 12 levels were classified as grade III and three levels were classified as grade IV. Three patients developed recurrent cervical radiculopathy or myelopathy due to adjacent segment disease and received the reoperations. The reoperations included two cases of cervical arthroplasty at adjacent segments and one case of cervical laminoplasty.
ProDisc-C arthroplasty had acceptable clinical and radiographic results at 10-year follow-up. Heterotopic ossification was common after ProDisc-C arthroplasty, which decreased the range of motion.
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Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M (2013) ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: five-year results of a Food and Drug Administration study. Spine (Phila Pa 1976) 38:203–209. https://doi.org/10.1097/BRS.0b013e318278eb38
Janssen ME, Zigler JE, Spivak JM, Delamarter RB, Darden BV 2nd, Kopjar B (2015) ProDisc-C total disc replacement versus anterior cervical discectomy and fusion for single-level symptomatic cervical disc disease: seven-year follow-up of the prospective randomized U.S. Food and Drug Administration investigational device exemption study. J Bone Joint Surg Am 97:1738–1747. https://doi.org/10.2106/JBJS.N.01186
McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J (2003) Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech 16:384–389
White AA, 3rd, Panjabi MM (1978) The basic kinematics of the human spine. A review of past and current knowledge. Spine (Phila Pa 1976) 3:12–20
Robertson JT, Papadopoulos SM, Traynelis VC (2005) Assessment of adjacent-segment disease in patients treated with cervical fusion or arthroplasty: a prospective 2-year study. J Neurosurg Spine 3:417–423. https://doi.org/10.3171/spi.2005.3.6.0417
Loumeau TP, Darden BV, Kesman TJ, Odum SM, Van Doren BA, Laxer EB, Murrey DB (2016) A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF). Eur Spine J 25:2263–2270. https://doi.org/10.1007/s00586-016-4431-6
Mehren C, Heider F, Siepe CJ, Zillner B, Kothe R, Korge A, Mayer HM (2017) Clinical and radiological outcome at 10 years of follow-up after total cervical disc replacement. Eur Spine J 26:2441–2449. https://doi.org/10.1007/s00586-017-5204-6
Delamarter RB, Zigler J (2013) Five-year reoperation rates, cervical total disc replacement versus fusion, results of a prospective randomized clinical trial. Spine (Phila Pa 1976) 38:711–717. https://doi.org/10.1097/BRS.0b013e3182797592
Murrey D, Janssen M, Delamarter R, Goldstein J, Zigler J, Tay B, Darden B (2009) Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 9:275–286. https://doi.org/10.1016/j.spinee.2008.05.006
Mehren C, Suchomel P, Grochulla F, Barsa P, Sourkova P, Hradil J, Korge A, Mayer HM (2006) Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976) 31:2802–2806. https://doi.org/10.1097/01.brs.0000245852.70594.d5
Cho YH, Kim KS, Kwon YM (2013) Heterotopic ossification after cervical arthroplasty with ProDisc-C: time course radiographic follow-up over 3 years. Korean J Spine 10:19–24. https://doi.org/10.14245/kjs.2013.10.1.19
Zhao YB, Sun Y, Zhou FF, Liu ZJ (2013) Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results. Chin Med J (Engl) 126:3809–3811
Yi S, Kim KN, Yang MS, Yang JW, Kim H, Ha Y, Yoon DH, Shin HC (2010) Difference in occurrence of heterotopic ossification according to prosthesis type in the cervical artificial disc replacement. Spine (Phila Pa 1976) 35:1556–1561. https://doi.org/10.1097/BRS.0b013e3181c6526b
Yi S, Shin DA, Kim KN, Choi G, Shin HC, Kim KS, Yoon DH (2013) The predisposing factors for the heterotopic ossification after cervical artificial disc replacement. Spine J 13:1048–1054. https://doi.org/10.1016/j.spinee.2013.02.036
Lou J, Li H, Rong X, Wu W, Liu H (2016) Location change of center of rotation after single-level cervical total disc replacement with ProDisc-C. Acta Orthop Traumatol Turc 50:339–345. https://doi.org/10.3944/AOTT.2016.15.0182
Zhou HH, Qu Y, Dong RP, Kang MY, Zhao JW (2015) Does heterotopic ossification affect the outcomes of cervical total disc replacement? A meta-analysis. Spine (Phila Pa 1976) 40:E332–E340. https://doi.org/10.1097/BRS.0000000000000776
Zhao Y, Zhang Y, Sun Y, Pan S, Zhou F, Liu Z (2016) Application of cervical arthroplasty with bryan cervical disc: 10-year follow-up results in China. Spine (Phila Pa 1976) 41:111–115. https://doi.org/10.1097/BRS.0000000000001145
Brenke C, Scharf J, Schmieder K, Barth M (2012) High prevalence of heterotopic ossification after cervical disc arthroplasty: outcome and intraoperative findings following explantation of 22 cervical disc prostheses. J Neurosurg Spine 17:141–146. https://doi.org/10.3171/2012.4.SPINE12223
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Zhao, Y., Zhou, F., Sun, Y. et al. Single-level cervical arthroplasty with ProDisc-C artificial disc: 10-year follow-up results in one centre. Eur Spine J 29, 2670–2674 (2020). https://doi.org/10.1007/s00586-019-06110-1
- Cervical disc arthroplasty
- Heterotopic ossification
- Adjacent segment disease