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Cervical arthroplasty

Jau-Ching Wu, Hsuan-Kan Chang, Wen-Cheng Huang, Tsung-Hsi Tu, Li-Yu Fay, Chao-Hung Kuo, Chih-Chang Chang, Ching-Lan Wu, Huang-Chou Chang, Henrich Cheng
BACKGROUND: This study aimed to investigate whether cervical disc arthroplasty (CDA) would be equally effective in elderly patients as in the young. The inclusion criteria of published clinical trials for CDA-enrolled patients covered the ages from 18 to 78 years. However, there was a paucity of data addressing the differences of outcomes between older and the younger patients. METHODS: A series of consecutive patients who underwent one- or two-level CDA were retrospectively reviewed...
March 18, 2019: BMC Musculoskeletal Disorders
Patrick Fransen, Niels Hansen-Algenstaedt, Athanasos Chatzisotiriou, David Cesar Gonzalez Noriega, Vincent Pointillart
We studied pain, neurological, and functional outcomes of one and two-levels cervical arthroplasties using a semi-constrained prosthesis for symptomatic cervical degenerative discopathies. Retrospective analysis of 95 patients in a multicentric registry over 2 years FU. Implant-related complications, subsequent surgery and neurological deterioration were not observed. After two years, improvement of > 20% of the NDI was observed in 81.8%, of > 20% of the neck pain in 75.5% and of 20% in arm pain in 77...
September 2018: Acta Orthopaedica Belgica
Keyvan Mostofi, Babak Gharaei Moghaddam, Morad Peyravi, Reza Karimi Khouzani
Objective: Anterior cervical arthroplasty (ACA) is the gold standard surgery in severe or unresponsive cases of cervical disc herniation, uncarthrosis, and foraminal stenosis. The aim of this study is to establish the impact and outcome evaluations of managing the patients operated for cervical arthroplasty by the intersomatic porous alumina ceramic cervical cages (PACC). The authors describe their experience in the area to allow the comparison of effectiveness of ceramic cages versus other interbody fusion cages...
October 2018: Journal of Craniovertebral Junction and Spine
Ting-Kui Wu, Yang Meng, Hao Liu, Bei-Yu Wang, Ying Hong, Xin Rong, Chen Ding, Hua Chen
BACKGROUND CONTEXT: Surgery for cervical degenerative disc disorder (CDDD) at two noncontiguous segments is infrequent. Few studies have explored the biomechanical effects on the intermediate adjacent segment of anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDA) in this situation. No study has examined biomechanical differences between ACDF and hybrid surgery (HS) constructs for noncontiguous CDDD. Differences in the biomechanical changes between the intermediate and adjacent segments are unknown...
February 8, 2019: Spine Journal: Official Journal of the North American Spine Society
Ting-Kui Wu, Yang Meng, Bei-Yu Wang, Xin Rong, Ying Hong, Chen Ding, Hua Chen, Hao Liu
BACKGROUND: Moderately increased motion at the intermediate segment (IS) after skip-level fusion may accelerate disc degeneration. However, limited biomechanical data are available that examine the effects on the IS following cervical disc arthroplasty (CDA). The purpose of this study is to investigate the biomechanical changes in the IS of the cervical spine after skip-level fusion or skip-level arthroplasty. METHODS: A finite element model of a healthy cervical spine (C2-C7) was constructed...
January 31, 2019: BMC Musculoskeletal Disorders
Robert M Havey, Saeed Khayatzadeh, Leonard I Voronov, Kenneth R Blank, Gerard Carandang, David P Harding, Avinash G Patwardhan
BACKGROUND: Cervical fusion is associated with adjacent segment degeneration. Cervical disc arthroplasty is considered an alternative to reduce risk of adjacent segment disease. Kinematics after arthroplasty should closely replicate healthy in vivo kinematics to reduce adjacent segment stresses. The purpose of this study was to assess the kinematics of a polycrystalline diamond cervical disc prosthesis. METHODS: Nine cadaveric C3-T1 spines were tested intact and after one (C5-C6) and two level (C5-C7) arthroplasty (Triadyme-C, Dymicron Inc...
January 4, 2019: Clinical Biomechanics
Andrei F Joaquim, Melvin C Makhni, K Daniel Riew
INTRODUCTION: Cervical disc arthroplasty (CDA) was developed to decrease the rate of symptomatic adjacent-level disease while preserving motion in the cervical spine. METHODS: The objectives of this paper are to provide criteria for proper patient selection as well as to present a comprehensive literature review of the current evidence for CDA, including randomized studies, the most recent meta-analysis findings, and long-term follow-up clinical trials as well. RESULTS: Currently, there are several prospective randomized controlled studies of level I of evidence attesting to the safety and efficacy of CDA in the management of cervical spondylotic disease (CSD) for one- or two-level degenerative diseases...
January 8, 2019: International Orthopaedics
David S Casper, Gregory D Schroeder, Benjamin Zmistowski, Jeffery A Rihn, D Greg Anderson, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler
Two major forms of physician reimbursement include Medicare (MCR; federally funded) and Medicaid (MCD; state funded). The only oversight provided to individual states for setting MCD reimbursement is that it must provide a standard payment that does not negatively affect patient care. The goals of this study were to determine the variability of MCD reimbursement for patients who require orthopedic procedures and to assess how this compares with regional MCR reimbursement. Medicaid reimbursement rates from each state were obtained for total knee arthroplasty, total hip arthroplasty, anterior cruciate ligament repair, rotator cuff repair, anterior cervical decompression and fusion, posterior lumbar decompression, carpal tunnel release, distal radius open reduction and internal fixation, proximal femur open reduction and internal fixation, and ankle open reduction and internal fixation...
December 31, 2018: Orthopedics
Daniel A Tarazona, Gregory D Schroeder, Alexander R Vaccaro, Kris E Radcliff
Over the last decade, several of the Food and Drug Administration-regulated investigational device exemption (IDE) trials have compared multiple cervical disk arthroplasty (CDA) devices to anterior cervical decompression and fusion (ACDF) showing comparable and even superior patient-reported outcomes. CDA has been an increasingly attractive option because of the positive outcomes and the motion-preserving technology. However, with the large burden that health care expenditures place on the economy, the focus is now on the value of treatment options...
December 28, 2018: Clinical Spine Surgery
Carmen L A Vleggeert-Lankamp, Tessa M H Janssen, Erik van Zwet, Caroline M W Goedmakers, Lisette Bosscher, Wilco Peul, Mark P Arts
BACKGROUND: Motion preserving anterior cervical disc arthroplasty (ACDA) in patients with cervical radiculopathy was introduced to prevent symptomatic adjacent disc degeneration as compared with anterior cervical discectomy and fusion (ACDF). Prior reports suggest that ACDF is not more effective than anterior cervical discectomy (ACD) alone for the treatment of cervical radiculopathy. PURPOSE: To evaluate whether patients with cervical radiculopathy due to a herniated disc benefit more from undergoing ACDA, ACDF, or ACD in terms of clinical outcome measured by the neck disability index (NDI)...
December 21, 2018: Spine Journal: Official Journal of the North American Spine Society
Timothy R Niedzielak, Bijan J Ameri, Blaze Emerson, Rushabh M Vakharia, Martin W Roche, John P Malloy
Background: Due to increased postoperative complications with anterior cervical discectomy and fusion (ACDF), there has been an increasing interest in the use of cervical disc arthroplasty (CDA). Advancements in prosthetic designs and techniques have improved patient reported outcome measurements and minimized revision rates. There is a paucity in the literature regarding recent trends in CDA utilization and revision rates. The purpose of this study was to determine annual primary and revision CDA trends with the use of an administrative database...
September 2018: Journal of Spine Surgery (Hong Kong)
Chih-Chang Chang, Wen-Cheng Huang, Jau-Ching Wu, Praveen V Mummaneni
Cervical disc arthroplasty (CDA), or total disc replacement, has emerged as an option in the past two decades for the management of 1- and 2-level cervical disc herniation and spondylosis causing radiculopathy, myelopathy, or both. Multiple prospective randomized controlled trials have demonstrated CDA to be as safe and effective as anterior cervical discectomy and fusion, which has been the standard of care for decades. Moreover, CDA successfully preserved segmental mobility in the majority of surgical levels for 5-10 years...
December 14, 2018: Neurospine
Patrick Hill, Avani Vaishnav, Blake Kushwaha, Steven McAnany, Todd Albert, Catherine Himo Gang, Sheeraz Qureshi
Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery...
September 9, 2018: Neurospine
Anna MacDowall, Martin Skeppholm, Lars Lindhagen, Yohan Robinson, Håkan Löfgren, Karl Michaëlsson, Claes Olerud
OBJECTIVEThe long-term efficacy of artificial disc replacement (ADR) surgery compared with fusion after decompression for the treatment of cervical degenerative disc disease and radiculopathy has not previously been investigated in a population-based setting.METHODSAll patients with cervical degenerative disc disease and radiculopathy who were in the national Swedish Spine Registry (Swespine) beginning in January 1, 2006, were eligible for the study. Follow-up information was obtained up to November 15, 2017...
November 2, 2018: Journal of Neurosurgery. Spine
Cedric Baltus, Emmanuel Costa, Geraldo Vaz, Christian Raftopoulos
BACKGROUND: Cervical Total Disc Arthroplasty (TDA) or cervical artificial disc replacement (C-ADR) is an alternative technique to anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic degenerative cervical spine disease. The main goal of TDA is to maintain cervical motion and therefore lower the risk of adjacent levels' deterioration. Granuloma formation on a cervical TDA is exceptional. We report such a case. CLINICAL PRESENTATION: A 48-year-old female suffering from left cervico-brachialgia underwent a double-level TDA (SpinalKinetics® M6-C Artificial Cervical Disc) on C5-C6 and C6-C7 in another hospital in 2010...
November 17, 2018: World Neurosurgery
Simon Mazas, Ahmed Benzakour, Jean-Etienne Castelain, Camille Damade, Soufiane Ghailane, Olivier Gille
PURPOSE: Cervical disc herniation is a common pathology. It can be treated by different surgical procedures. We aimed to list and analyzed every available surgical option. We focused on the comparison between anterior cervical decompression and fusion and cervical disc arthroplasty. RESULTS: The anterior approach is the most commonly used to achieve decompression and fusion by the mean of autograft or cage that could also be combined with anterior plating. Anterior procedures without fusion have shown good outcomes but are limited by post-operative cervicalgia and kyphotic events...
November 8, 2018: International Orthopaedics
Matthew F Gornet, Jeffrey R McConnell, K Daniel Riew, Todd H Lanman, J Kenneth Burkus, Scott D Hodges, Randall F Dryer, Anne G Copay, Francine W Schranck
STUDY DESIGN: Analysis of 2- and 7-year outcomes from a clinical trial comparing 2-level cervical disk arthroplasty (CDA) to anterior cervical discectomy and fusion (ACDF) in 287 patients with radiculopathy alone, and 110 patients with myelopathy alone or myelopathy with radiculopathy. OBJECTIVE: To compare the long-term safety and effectiveness of CDA for myelopathy versus radiculopathy. SUMMARY OF BACKGROUND DATA: CDA for myelopathy is safe and effective in short term...
December 2018: Clinical Spine Surgery
Emma Turesson, Kjell Ivarsson, Karl-Göran Thorngren, Ami Hommel
BACKGROUND: Nearly 18,000 individuals suffer from hip fracture in Sweden each year. The choice in operation method for femoral neck fractures has changed over the years as well as the overall management. Functional outcome after hip fracture is affected by several factors and the overall functional level for old people in Sweden has improved over the last decades. OBJECTIVE: To describe and analyse the functional outcome and choice of operation method for hip fracture patients between 1988 and 2012...
December 2018: Injury
Matthew F Gornet, Glenn R Buttermann, Richard Wohns, Jason Billinghurst, Darrell C Brett, Richard Kube, J Rafe Sales, Nicholas J Wills, Ross Sherban, Francine W Schranck, Anne G Copay
Background: Outpatient surgery has been shown safe and effective for anterior cervical discectomy and fusion (ACDF), and more recently, for 1-level cervical disc arthroplasty (CDA). The purpose of this analysis is to compare the safety and efficiency of 1-level and 2-level CDA performed in an ambulatory surgery center (ASC) and in a hospital setting. Methods: The study was a retrospective collection and analysis of data from consecutive CDA patients treated in ASCs compared to a historical control group of patients treated in hospital settings who were classified as outpatient (0 or 1-night stay) or inpatient (2 or more nights)...
October 2018: International Journal of Spine Surgery
David Christopher Kieser, Derek Thomas Cawley, Takashi Fujishiro, Celeste Tavolaro, Simon Mazas, Louis Boissiere, Ibrahim Obeid, Vincent Pointillart, Jean Marc Vital, Olivier Gille
Study Design: Retrospective, longitudinal observational study. Purpose: To describe the natural history of anterior bone loss (ABL) in cervical disc arthroplasty (CDA) and introduce a classification system for its assessment. Overview of Literature: ABL has recently been recognized as a complication of CDA, but its cause and clinical effects remain unknown. Methods: Patients with non-keeled CDA (146) were retrospectively reviewed...
October 18, 2018: Asian Spine Journal
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