Hui Nicholas, Phan Kevin, Kerferd Jack, Lee Meiyi, Mobbs Ralph J
NeuroSpine Surgery Research Group (NSURG), The University of New South Wales, Sydney, NSW, Australia.
J Spine Surg. 2019 Dec;5(4):393-403. doi: 10.21037/jss.2019.09.27.
Cervical total disc replacement (CTDR) is complicated by adjacent segment degeneration (ASD). Since non-physiological spine kinematics after CTDR was postulated to cause ASD, M6-C prosthesis has been developed to better replicate the natural kinematics of the intervertebral disc. This retrospective cohort study aims to compare the short-term outcomes between patients receiving either the M6-C or Mobi-C prostheses.
Patients who had refractory radiculopathy and/or myelopathy secondary to cervical degenerative disc disease and underwent CTDR between March 2004 and April 2017 were included. All CTDRs were performed by a single surgeon at a single institution. Self-reported clinical outcomes and radiological parameters were evaluated at baseline and final follow-up between March 2004 and April 2018.
Sixty-two patients with greater than 1-year follow-up or who developed HO within 12 months of surgery, were included in the study. The mean radiological follow-up was 29.0 months (3-84 months), which includes 7 patients with less than 12 months follow-up who also developed HO. The changes in clinical and radiological measures were comparable between M6-C and Mobi-C prostheses. Thirty-seven out of 52 spinal segments (71.2%) and 10 out of 16 spinal segments (62.5%) developed HO in M6-C and Mobi-C group respectively. There was no significant difference in the rate of HO between the two groups.
No short-term differences were found in clinical or radiological outcomes between patients who received either the M6-C or Mobi-C prosthesis. Further randomized trials with a long-term follow-up period are warranted to determine the safety and efficacy of M6-C prosthesis.
颈椎全椎间盘置换术(CTDR)会并发相邻节段退变(ASD)。由于推测CTDR后非生理性脊柱运动学改变会导致ASD,因此研发了M6-C假体以更好地复制椎间盘的自然运动学。这项回顾性队列研究旨在比较接受M6-C或Mobi-C假体的患者的短期疗效。
纳入2004年3月至2017年4月间因颈椎间盘退变继发难治性神经根病和/或脊髓病而接受CTDR的患者。所有CTDR均由同一机构的同一位外科医生进行。在2004年3月至2018年4月的基线和最终随访时评估自我报告的临床疗效和放射学参数。
62例随访超过1年或在术后12个月内发生异位骨化(HO)的患者纳入研究。平均放射学随访时间为29.0个月(3 - 84个月),其中包括7例随访时间不足12个月且也发生HO的患者。M6-C和Mobi-C假体在临床和放射学指标变化方面具有可比性。M6-C组52个脊柱节段中的37个(71.2%)和Mobi-C组16个脊柱节段中的10个(62.5%)发生了HO。两组之间HO发生率无显著差异。
接受M6-C或Mobi-C假体的患者在临床或放射学疗效方面未发现短期差异。有必要进行进一步的长期随访随机试验以确定M6-C假体的安全性和有效性。