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Intervertebral disc replacement for cervical degenerative disease – clinical results and functional outcome at two years in patients implanted with the Bryan® cervical disc prosthesis

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Summary

Background. This is a prospective study of patients with degenerative cervical disease who underwent ventral discectomy and disc replacement with the Bryan® cervical disc prosthesis. The objective was to investigate clinical outcome at 2 years of patients implanted with the Bryan® disc and to evaluate function of the implant itself.

Methods. Fifty-four consecutive patients with cervical disc herniation and/or spondylosis with preserved mobility in the affected spinal segments were enrolled. Patients presented clinically with cervical radiculopathy and/or myelopathy with or without neck pain. A standard anterior cervical discectomy was carried out and a Bryan® disc was implanted in the affected levels. A total of 59 prosthetic discs were implanted, in 49 patients at a single level and in 5 at two adjacent levels. The neurological status was evaluated pre-operatively and at one and two years thereafter. Plain X-rays, CT, and MRI were used for pre-operative diagnostics. Post-operative follow-up was done by X-rays.

Findings. All patients had an excellent or good neurological outcome according to the Odom criteria. Loss of function (motion range <3°) was found in 7 (12%) out of 59 Bryan® discs at two years after surgery. Heterotopic ossification (HO) of the McAffee grades 1–4 was seen in a total of 17 (29%) segments. There were no implant dislocations or migrations.

Conclusions. Implantation of the Bryan® disc resulted in excellent or good neurological outcome in all patients. The surgical technique was safe and without complications. Twelve percent of the implanted Bryan® discs lost mobility at two years, mainly due to HO. A trend was seen towards development of HO in the operated segments.

Further investigations with longer follow-up periods and with a control group (e.g. fusion with intervertebral cage) will be necessary for a definitive assessment of the long-term functionality and benefits of artificial cervical discs.

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Authors and Affiliations

  1. Department of Neurosurgery, Klinikum Augsburg, Augsburg, Germany

    V. Heidecke & N. G. Rainov

  2. Department of Neurosurgery, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany

    V. Heidecke, W. Burkert, M. Brucke & N. G. Rainov

Authors
  1. V. Heidecke
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  2. W. Burkert
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  3. M. Brucke
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  4. N. G. Rainov
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Corresponding author

Correspondence to V. Heidecke.

Additional information

Correspondence: Dr. Volkmar Heidecke, Department of Neurosurgery, Klinikum Augsburg, Stenglinstrasse 2, 86156 Augsburg, Germany.

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Heidecke, V., Burkert, W., Brucke, M. et al. Intervertebral disc replacement for cervical degenerative disease – clinical results and functional outcome at two years in patients implanted with the Bryan® cervical disc prosthesis. Acta Neurochir (Wien) 150, 453–459 (2008). https://doi.org/10.1007/s00701-008-1552-7

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  • DOI: https://doi.org/10.1007/s00701-008-1552-7

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