Duggal Neil, Bertagnoli Rudolf, Rabin Doron, Wharton Nicholas, Kowalczyk Izabela
Division of Neurosurgery, London Health Sciences Center, London, Ontario, Canada.
J Spinal Disord Tech. 2011 Jul;24(5):334-9. doi: 10.1097/BSD.0b013e3181fbf8aa.
A prospective study of 22 patients with single-level cervical spondylosis.
To quantify the changes in the biomechanics of the cervical spine after the insertion of a ProDisc-C (Synthes Spine, Paoli, PA) artificial disc.
Cervical arthroplasty is designed to maintain cervical motion of the functional spinal unit (FSU) after cervical discectomy. The impact of the ProDisc-C on in vivo kinematics and sagittal alignment requires further assessment.
Flexion/extension lateral radiographs of the cervical spine were prospectively collected and reviewed in 22 patients preoperatively and after the placement of ProDisc-C. Disc height (DH), FSU angle, range of motion (ROM), and center of rotation (COR) were calculated at each time point using validated, computer-assisted methods. Preoperative values were compared with the postoperative values using paired student t tests.
Mean follow-up time was 11.0 months (SD, 2.4 mo). At the surgical level, the ProDisc-C produced increased segmental ROM (P = 0.03), an anterior shift of 1.1 mm in COR X (P = 0.004), and increased DH both anteriorly (P < 0.0001) and posteriorly (P < 0.0001). At the inferior adjacent level, anterior DH decreased (P < 0.05) and posterior DH increased (P = 0.02) after surgery. The FSU angle at the surgical level increased (P < 0.0001), but the inferior adjacent-level FSU angle decreased (P = 0.002). No significant changes were observed at the superior adjacent level.
The ProDisc-C increased segmental ROM and shifted the COR anteriorly at the surgical level. DH increased at the surgical level. The surgical level became more lordotic, whereas the inferior adjacent level became more kyphotic after ProDisc-C implantation.
对22名单节段颈椎病患者进行的前瞻性研究。
量化植入ProDisc-C（辛迪斯脊柱公司，宾夕法尼亚州波利）人工椎间盘后颈椎生物力学的变化。
颈椎置换术旨在在颈椎间盘切除术后维持功能性脊柱单元（FSU）的颈椎活动度。ProDisc-C对体内运动学和矢状位排列的影响需要进一步评估。
前瞻性收集并回顾了22例患者术前及植入ProDisc-C后的颈椎屈伸侧位X线片。使用经过验证的计算机辅助方法在每个时间点计算椎间盘高度（DH）、FSU角度、活动范围（ROM）和旋转中心（COR）。使用配对学生t检验将术前值与术后值进行比较。
平均随访时间为11.0个月（标准差，2.4个月）。在手术节段，ProDisc-C使节段性ROM增加（P = 0.03），COR X向前移位1.1 mm（P = 0.004），前后方DH均增加（前方P < 0.0001，后方P < 0.0001）。在相邻下位节段，术后前方DH减小（P < 0.05），后方DH增加（P = 0.02）。手术节段的FSU角度增加（P < 0.0001），但相邻下位节段的FSU角度减小（P = 0.002）。在相邻上位节段未观察到显著变化。
ProDisc-C增加了手术节段的节段性ROM并使COR向前移位。手术节段的DH增加。植入ProDisc-C后，手术节段的前凸增加，而相邻下位节段的后凸增加。
