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Clinical and radiological results of total disc replacement in the cervical spine with preoperative reducible kyphosis

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Abstract

Purpose

To investigate the clinical and radiological results of total disc replacement (TDR) in the cervical spine with preoperative reducible kyphosis, and discuss when TDR is indicated for the patients with preoperative kyphosis.

Methods

Fifty-two patients who underwent single-level cervical TDR from June 2008 to May 2010 were included in this study. TDR was indicated for patients with preoperative lordosis or reducible kyphosis, and the patients were divided into a lordotic group (preoperative global angle of ≥0°) and kyphotic group (preoperative global angle of <0°). Clinical results were evaluated using the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score and Neck Disablity Index (NDI). For radiological evaluation, the global and functional spinal unit (FSU) angles and the global and FSU range of motion were measured preoperatively and postoperatively.

Results

The mean NDI in the kyphotic group was significantly higher than that in the lordotic group preoperatively and at six months postoperatively, but the groups showed no significant differences in JOA score, VAS score and NDI at the two year follow-up. The mean global and FSU angles in the kyphotic group were significantly lower than those in the lordotic group preoperatively and at six months postoperatively, but they gradually improved postoperatively. The differences lost significance at the two year follow-up.

Conclusions

Postoperative cervical kyphosis had adverse effects on the NDI after TDR. Artificial discs, symptom relief, and neck functional exercises may contribute to correction of preoperative reducible kyphosis at different stages after cervical TDR. Preoperative reducible kyphosis should not be an independent contraindication for cervical TDR.

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Conflicts of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Orthopedic Research Institute of the Chinese People’s Liberation Army, Department of Orthopedic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China

    Yu Chen, Haisong Yang, Xinwei Wang & Deyu Chen

  2. Department of Orthopedic Surgery, Fengxian Branch of the Shanghai No.6 People’s Hospital, Shanghai, China

    Zhimin He

Authors
  1. Yu Chen
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  2. Zhimin He
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  3. Haisong Yang
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  4. Xinwei Wang
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  5. Deyu Chen
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Correspondence to Deyu Chen.

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The first two authors have equally contributed to the writing of this article.

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Chen, Y., He, Z., Yang, H. et al. Clinical and radiological results of total disc replacement in the cervical spine with preoperative reducible kyphosis. International Orthopaedics (SICOT) 37, 463–468 (2013). https://doi.org/10.1007/s00264-012-1754-8

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  • DOI: https://doi.org/10.1007/s00264-012-1754-8

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