Abstract
ObjectivesTo investigate clinical effects and manual operational point of Bryan cervical disc prosthesis in Chinese, to observe the stability and range of movement (ROM) post-operatively.Methods and materialsFrom 2003,12 to 2005,12, Bryan disc prosthesis replacement applied in 83 cases (102 levels) of cervical spondylotic myelopathy (CSM) after anterior decompression in our hospital. Clinical (JOA grade and Odom's scale) and radiological (X-ray of flexion, extension; left and right bending position) follow-up was performed. Systemic radiographic study about stability and ROM of replaced level post operationally were measured. CT or MRI scans were applied in all cases to evaluate the signs of the prosthesis deflexion and hetero-ossification in the replaced levels.ResultsAt least 12 months follow-up were done in 65/83 of these paients. All of 83 patients were improved according to Odsm's scale. JOA score increased from average 8.7 to 15.5. There was no prosthesis subsidence. Replaced segment achieved stability and restored partial of normal ROM 4.73°(3.7°–5.9°) early postoperation and 8.12°(5.8°–13.6°) more than 12 months postoperation in flex and extension position. No obvious loss of lordosis was found. CT or MRI follow-up shows position deflexion of the prosthesis metal endplates (<1.5 mm) in 14/77 levels and (1.5~3 mm) in 4/77. heter-ossification was found in the replaced levels only in 2 cases.ConclusionByran cervical disc prosthesis restored motion to the level of the intact segment in flexion-extension and lateral bending in post-operative images. At the same time, it can achieve good anterior decompression treatment effect and immediate stability in replaced 1 or 2 levels, and which is a new choice for the treatment of CSM.
Highlights
Anterior cervical decompression and fusion have traditionally been considered one of the most successful of cervical spine surgeries; the problems associated with cervical fusion have been illuminated recently [1,2]
CT or Magnetic Resonance Imaging (MRI) follow-up shows position deflexion of the prosthesis metal endplates (
Byran cervical disc prosthesis restored motion to the level of the intact segment in flexion-extension and lateral bending in post-operative images. It can achieve good anterior decompression treatment effect and immediate stability in replaced 1 or 2 levels, and which is a new choice for the treatment of cervical spondylotic myelopathy (CSM)
Summary
Anterior cervical decompression and fusion have traditionally been considered one of the most successful of cervical spine surgeries; the problems associated with cervical fusion have been illuminated recently [1,2]. Several studies on the effectiveness of Bryan cervical disc prosthesis in treating radiculopathy, spondylotic myelopathy have been conducted in Europe and Australia. No study on the clinical result of Bryan cervical disc prosthesis in China has been reported. No systematic radiographic study among Chinese about the post operation result on range of motion (ROM) of replaced level or stability of the prosthesis has been reported either. In order to find out the clinical result of CSM of which among Chinese, a prospective but non-random clinical and radiographic study was conducted in our hospital (one of the largest orthopaedic department in China). The main purpose of this study is to find out the treatment result and key points in the operation procedure of Bryan cervical disc prosthesis among Chinese. The post-operation stability and range of motion were measured
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