gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Restoration of life quality 24 months after cervical spine non-fusion using dynamic cervical implant

Meeting Abstract

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  • J. Herdmann - Klinik Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf
  • B. Zillner - Klinik Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf
  • P. Buddenberg - Klinik Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf
  • A. Pilz - Klinik Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf
  • F. Floeth - Klinik Wirbelsäule & Schmerz, St. Vinzenz-Krankenhaus, Düsseldorf

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocDO.13.05

doi: 10.3205/12dgnc118, urn:nbn:de:0183-12dgnc1189

Published: June 4, 2012

© 2012 Herdmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Numerous implants for cervical disc replacement aim at maintaining or restoring mobility. The Dynamic Cervical Implant (DCI™, Paradigm Spine) seeks to combine the advantages of the gold standard fusion technique with the motion preservation philosophy. DCI has a constrained motion: it works like a shock absorbing spring and may help to slow down adjacent segment degeneration.

Methods: Between 2007 and 2011 we selected 121 patients aged 32 to 73 years for treatment with DCI at either one or two levels (13 patients). Indications were radiculopathies (n = 69), axial pain (n = 6) or spondylotic spinal stenosis (n = 46) without chronic myelopathy. Patients were followed up at 3, 6, 12 (n > 100), and 24 (n > 70) months after surgery using NDI, pain and satisfaction questionnaires as well as SF12.

Results: Disc surgery was performed at C3/C4 (n = 2), C4/5 (n = 8), at C5/6 (n = 65), C6/7 (n = 57) and at C7/T1 (n = 2). In flexion/extension radiographs segmental mobility was soon regained after surgery. 1% of operated segments fused within 6 months, 9% within 12 months, and 11% within 24 months. More than 90% of the patients rated their clinical result as excellent or good. Neck pain, arm pain, and NDI continuously decreased in successive follow-ups. SF12-measures returned to normal (physical score) and even reached scores better than normal (mental scores). Correspondingly all satisfaction scores continuously increased. Anterior migration of the implant resulted in fusion of the operated segment (2 cases) without need for additional measures. There was no implant related complication or revision surgery.

Conclusions: Cervical disc replacement with DCI is positioned in between ACDF and TDR. Inadvertent fusion was seen in 9% during the first 12 months after surgery but it increased by only 2% in the second year of follow-up. Clinical results after 24 months are as good as or better than in ACDF. Adjacent segment protection may be liable for this improvement, which is associated with enhanced life quality.