부산대학교 도서관

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jocn.2008.01.021 Byline: Markus Wenger (a), Petrus van Hoonacker (b), Benoit Zachee (b), Robert Lange (c), Thomas-Marc Markwalder (d) Keywords: Adjacent segment; Cervical spine; Disc herniation; Range of motion; Spine surgery; Total disc arthroplasty Abstract: Preserving the function of cervical disc prostheses, even over the short term, is a matter of concern among surgeons. Our case series highlights our results and protocol for increasing the probability of continued device function. Twenty-five consecutive patients with a mean ([+ or -]SEM) age of 44.3[+ or -]8.3 years underwent 29 cervical total disc arthroplasties for disc herniations. Three patients underwent primary bilevel arthroplasty, and one patient underwent a second arthroplasty for another herniation 2 years after the first. Prosthesis ranges of motion were measured using dynamic plain X-ray studies and compared to the ranges of motion of adjacent segments. At follow-up, all prostheses were in the correct location and without subsidence. All displayed firm secondary stability. One segment had fused. Twenty-eight of 29 devices were mobile an average of 9.5[degrees][+ or -]4.7[degrees] (range 3[degrees] to 20[degrees]) (for all 29 devices the average movement angle was 9.2[degrees][+ or -]5[degrees]; range 0[degrees] to 20[degrees]), 25 upper adjacent segments were mobile an average of 10.9[degrees][+ or -]4.5[degrees] (range 2[degrees] to 20[degrees]) (excluding the fused prosthesis: 11[degrees][+ or -]4.6[degrees]) and 15 lower adjacent segments were mobile an average of 9.8[degrees][+ or -]6[degrees] (range 1[degrees] to 21[degrees]). With our protocol, 28 of 29 cervical disc prostheses in 25 consecutive patients were mobile after an average of 22.3[+ or -]9.4 months. Prosthesis motion was physiological and very similar to that of the healthy adjacent segments. Long-term studies including larger numbers of patients are required to validate our initial observations. Author Affiliation: (a) Hirslanden Group, Klinik Beau-Site, Schanzlihalde 11, CH-3000 Bern 25, Switzerland (b) AZ Waasland Lodewijk, St Niklaas, Belgium (c) CoLigne AG, Zurich, Switzerland (d) FMH, Thunstrasse 160, Bern-Muri, Switzerland Article History: Received 19 October 2007; Accepted 27 January 2008