J Neurol Surg A Cent Eur Neurosurg 2022; 83(01): 027-030
DOI: 10.1055/s-0041-1724109
Original Article

Single-Level Cervical Arthroplasty with a Keel-less Prosthesis: Results in a Series of 35 Patients Operated on for Soft Disk Herniation with a Minimum of 3 Years of Follow-Up

1   Department of Neurosurgery, Catholic University of the Sacred Heart Rome Campus, Roma, Italy
,
Giovanni Stati
2   Department of Neurosurgery, Azienda Complesso Ospedaliero San Filippo Neri, Roma, Lazio, Italy
,
Carlo Giacobbo Scavo
2   Department of Neurosurgery, Azienda Complesso Ospedaliero San Filippo Neri, Roma, Lazio, Italy
,
Ettore Carpineta
2   Department of Neurosurgery, Azienda Complesso Ospedaliero San Filippo Neri, Roma, Lazio, Italy
,
Guglielmo Cacciotti
2   Department of Neurosurgery, Azienda Complesso Ospedaliero San Filippo Neri, Roma, Lazio, Italy
,
Raffaelino Roperto
2   Department of Neurosurgery, Azienda Complesso Ospedaliero San Filippo Neri, Roma, Lazio, Italy
,
Albert Sufianov
3   Department of Neurosurgery, Sechenov University, Moskva, Russian Federation
,
Luciano Mastronardi
2   Department of Neurosurgery, Azienda Complesso Ospedaliero San Filippo Neri, Roma, Lazio, Italy
› Author Affiliations

Abstract

Background Cervical arthroplasty with artificial cervical disks has gained popularity as an alternative to anterior discectomy and fusion. The main advantages of disk arthroplasty include maintenance of the range of movement, restitution of disk height and spinal alignment, and reduction of adjacent segment degeneration (ASD). In this article, we aimed to assess the outcomes of the use of a keel-less prosthesis.

Material and Methods We included all the patients who underwent single-level cervical arthroplasties with the Discocerv Cervidisc Evolution for “soft” disk herniation. Clinical assessment included Neck Disability Index (NDI) and visual analog scale (VAS) for neck and arm pain. Radiologic studies investigated the occurrence of ASD and system failure or subsidence. The reoperation rate was also recorded.

Results The study included 35 patients (14 men and 21 women; mean age: 42.5 years; mean follow-up: 57.8 months). There was a significant decrease in VAS neck and VAS arm scores, which went from 7.2 and 6.9 preoperatively to 2.2 and 1.7 postoperatively, 2.2 and 1.6 at 6 months, 2.0 and 1.8 at 1 year, and 2.1 and 1.3 at the last follow-up, respectively. The mean NDI score was 58.0 preoperatively, 19.4 postoperatively, 17.0 at 6 months, 16.1 at 1 year, and 16.2 at the last follow-up. Radiologic studies revealed a preserved range of motion in 33 of 35 patients. No ASD occurred and no reoperation was required.

Conclusions Cervical disk arthroplasty with a keel-less prosthesis can be a safe and effective alternative to fusion for degenerative disk disease in selected patients, with a possible reduction of ASD.



Publication History

Received: 20 May 2020

Accepted: 22 September 2020

Article published online:
27 May 2021

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