In Vitro Biomechanics of Cervical Arthroplasty with Bryan Disc Prosthesis or ProDisc-C Prosthesis: A Cadaveric Study

Abstract

Introduction The purpose of this study is to compare the biomechanical performances of ProDisc-C arthroplasty and Bryan disc arthroplasty. Materials and Methods Six human cadaveric cervical spines were used in this study. After testing in the intact condition, all the specimens were reconstructed at C45 level with the following procedures: (1) cervical arthroplasty with ProDisc-C prosthesis; (2) cervical arthroplasty with Bryan disc prosthesis; (3) allograft and cervical plate. Range of motion and intradiscal pressures (IDPs) were recorded under flexion/extension, lateral bending, and rotations. Results (1) Comparing to normal model, both Bryan disc and ProDisc-C prosthesis maintained the motion of the operative segment. The ROM was also similar between the ProDisc-C group and Bryan group under all six directional motions. (2) In the ProDisc-C group, the IDPs of adjacent segments trended to decrease; The IDPs of C34 under right bending and left rotation reached a statistical significance. In the Bryan group, the IDPs of adjacent segments also trended to decrease and the IDPs of C34 under left bending reached a statistical significance. Conclusion ProDisc-C prosthesis and Bryan disc prosthesis maintained the ROM in all modes of motion. The adjacent segment IDPs both trended to decrease after ProDisc-C arthroplasty and Bryan disc arthroplasty. Disclosure of Interest None declared References Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis. J Bone Joint Surg Am 1999;81(4):519–528 Goffin J, Casey A, Kehr P, et al. Preliminary clinical experience with the Bryan Cervical Disc Prosthesis. Neurosurgery 2002;51(3):840-845, discussion 845–847 Walraevens J, Demaerel P, Suetens P, et al. Longitudinal prospective long-term radiographic follow-up after treatment of single-level cervical disk disease with the Bryan Cervical Disc. Neurosurgery 2010;67(3):679-687, discussion 687 Zhao YB, Sun Y, Chen ZQ, Liu ZJ. Application of cervical arthroplasty with Bryan cervical disc: long-term X-ray and magnetic resonance imaging follow-up results. Chin Med J (Engl) 2010;123(21):2999–3002 Sasso RC, Anderson PA, Riew KD, Heller JG. Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. J Bone Joint Surg Am 2011;93(18):1684–1692 Murrey D, Janssen M, Delamarter R, et al. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease. Spine J 2009;9(4):275–286 Zigler JE, Delamarter R, Murrey D, Spivak J, Janssen M. ProDisc-C and anterior cervical discectomy and fusion as surgical treatment for single-level cervical symptomatic degenerative disc disease: five-year results of a Food and Drug Administration study. Spine 2013;38(3):203–209 Anderson PA, Sasso RC, Hipp J, Norvell DC, Raich A, Hashimoto R. Kinematics of the cervical adjacent segments after disc arthroplasty compared with anterior discectomy and fusion: a systematic review and meta-analysis. Spine 2012;37(22, Suppl)S85-S95 McAfee PC, Cunningham BW, Devine J, Williams E, Yu-Yahiro J. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech 2003;16(4):384–389 Sun Y, Zhao YB, Pan SF, Zhou FF, Chen ZQ, Liu ZJ. Comparison of adjacent segment degeneration five years after single level cervical fusion and cervical arthroplasty: a retrospective controlled study. Chin Med J (Engl) 2012;125(22):3939–3941 Zhao YB, Sun Y, Zhou FF, Liu ZJ. Cervical disc arthroplasty with ProDisc-C artificial disc: 5-year radiographic follow-up results. Chin Med J (Engl) 2013;126(20):3809–3811 Helgeson MD, Bevevino AJ, Hilibrand AS. Update on the evidence for adjacent segment degeneration and disease. Spine J 2013;13(3):342–351 Delamarter RB, Zigler J. Five-year reoperation rates, cervical total disc replacement versus fusion, results of a prospective randomized clinical trial. Spine 2013;38(9):711–717 Dmitriev AE, Cunningham BW, Hu N, Sell G, Vigna F, McAfee PC. Adjacent level intradiscal pressure and segmental kinematics following a cervical total disc arthroplasty: an in vitro human cadaveric model. Spine 2005;30(10):1165–1172 Chang UK, Kim DH, Lee MC, Willenberg R, Kim SH, Lim J. Changes in adjacent-level disc pressure and facet joint force after cervical arthroplasty compared with cervical discectomy and fusion. J Neurosurg Spine 2007;7(1):33–39