engleski

Complications of Single Level Cervical Discover Total Disc Replacement on Long Term Follow-up

Introduction : Anterior cervical decompression and fusion (ACDF) as standard treatment for symptomatic cervical disc disease has been challenged with the introduction of cervical arthroplasty in neurosurgical practice. Much has been debated on the potential benefit of motion preservation, as well as on the delayment of adjacent segment degeneration with the use of arthroplasty. Complication rates with arthroplasty are still to be seen on long term follow-up, and its potential advantage over ACDF in selected cases has yet to be confirmed. Material and Method : We analyzed the clinical and radiological data of patients operated on at our institution for single level cervical disc disease using arthroplasty, with the aim of identifying the complication rates on long term follow-up. All patients were operated on by the senior author (VM) and medical and radiological data were obtained at an outpatient basis on 3, 6, 12 and 24 months postoperatively. Results : In the period from Jan 2008 to Dec 2011 a total of 80 patients were operated on at our institution for single level cervical disc disease by total disc replacement using the Discover prosthesis. There were 44 females and 36 males, with age distribution between 22-58 (mean, 41). No perioperative complications such as hematoma or wound infection were observed. There was one intraoperative dural tear solved with fibrin glue. We detected a single case of prosthesis migration, which needed reoperation. 10 cases of heterotopic ossification were seen on follow-up radiological examination at 24 months postoperatively. Of these, motion was preserved in 2 cases at final follow-up. Conclusions : In our practice we have found no complications due to the arthroplasty device itself. At 2 year follow-up we detected a total of 11% of prosthesis malfunction, with 1% needing surgical reintervention. In our opinion Discover cervical TDR is a safe and efficient procedure with low complication rates.

Discover; Arthroplasty

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