Dynamic Cervical Implant (DCI) In Single Level Cervical Disc Disease

Abstract

Introduction: This study evaluated the safety and effectiveness of Dynamic Cervical Implants (DCI) as a form of dynamic instrumentation to treat single level cervical disc disease. This is a prospective case study of 15 consecutive patients, treated by the author, with single level cervical disc disease. Study duration was 3 years from October 2009 to October 2012. These 15 cases included 10 men and 5 women. Patient's ages ranged from 35 to 54 years (mean, 47 years). All patients had anterior cervical discectomy with interbody DCI implantation, at a single level from C3 to C7. Placement of the DCI implant aimed at reconstruction of the anterior column to preserve a controlled flexion and extension motion. Materials and Methods: Among the 15 cases, herniated cervical disc (HCD) accounted for 7 and cervical degenerative disc disease (DDD) for 8. Neck pain was present in all cases, radiculopathy in 9 cases, radiculomyelopathy in 4 cases and myelopathy in 2 cases. Preoperative evaluation included plain cervical x-rays including dynamic views. Magnetic reso- nance imaging (MRI) was carried out routinely to confirm the clinical diagnosis. Results: Our study showed that the procedure was safe and easy. There were no major complications. The most common DCI prosthesis used in this study was the 6M size with a width of 12 mm, a depth of 12 mm, and a height of 9 mm. No implant related complications were reported. This procedure has the advantages of shorter operative time; minimal blood loss; and early postoperative recovery. Neck pain and radiculopathy improved in 86.7% of cases, and myelopathy in 50% of cases. Hetertopic ossification indicating fusion was not observed. Conclusion: Disc replacement with DCI is a new strategy, in between ACDF & ADR. It is an intermediate solution in the spectrum of management strategies of cervical disc diseases. Immediate dynamic stability with good clinical response and no implant-related morbidity or complications are the main advantages of this implant.