Chang Nicholas, Mobbs Ralph, Hui Nicholas, Lin Henry
NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Randwick, Australia.
Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
J Craniovertebr Junction Spine. 2022 Jan-Mar;13(1):55-61. doi: 10.4103/jcvjs.jcvjs_92_21. Epub 2022 Mar 9.
Cervical total disc replacement (CTDR) is an alternative to anterior cervical discectomy and fusion for select patients that may preserve range of motion and reduce adjacent segment disease. Various CTDR prostheses are available; however, comparative data are limited. This study aimed to compare the short-term kinematic and radiological parameters of the M6-C, Mobi-C, and the CP-ESP prostheses.
This retrospective cohort study included patients treated with CTDR between March 2005 and October 2020 at a single institution. Patients were included if their follow-up assessment included lateral erect and flexion/extension radiographs. The primary outcome assessed at 3-months postoperatively was range of motion, measured by the difference in functional spinal unit angle between flexion and extension.
A total of 131 CTDR levels (120 patients, 46.2 ± 10.1 years, 57% male) were included. Prostheses implanted included the M6-C ( = 52), Mobi-C ( = 54), and CP-ESP ( = 25). Range of motion varied significantly (8.2° ± 4.4° vs. 10.9° ± 4.7° vs. 6.1° ± 2.7°, < 0.001). On post hoc analysis, the Mobi-C prosthesis demonstrated a significantly greater range of motion than either the M6-C prosthesis ( = 0.003) or CP-ESP ( < 0.001).
Although the optimal range of motion for CTDR has not been established, short-term differences in the range of motion may guide the selection of CTDR prosthesis. Further studies with longer follow-up and consideration of clinical outcome measures are necessary.
对于部分患者而言，颈椎全椎间盘置换术（CTDR）是前路颈椎间盘切除融合术的一种替代方案，它可能保留活动度并减少相邻节段疾病。有多种CTDR假体可供选择；然而，对比数据有限。本研究旨在比较M6-C、Mobi-C和CP-ESP假体的短期运动学和放射学参数。
这项回顾性队列研究纳入了2005年3月至2020年10月在单一机构接受CTDR治疗的患者。若患者的随访评估包括站立位侧位以及屈伸位X线片，则纳入研究。术后3个月评估的主要结局是活动度，通过屈伸位时功能脊柱单元角度的差值来测量。
共纳入131个CTDR节段（120例患者，年龄46.2±10.1岁，57%为男性）。植入的假体包括M6-C（n = 52）、Mobi-C（n = 54）和CP-ESP（n = 25）。活动度差异显著（8.2°±4.4° vs. 10.9°±4.7° vs. 6.1°±2.7°，P < 0.001）。事后分析显示，Mobi-C假体的活动度显著大于M6-C假体（P = 0.003）或CP-ESP假体（P < 0.001）。
尽管尚未确定CTDR的最佳活动度范围，但活动度的短期差异可能有助于指导CTDR假体的选择。有必要进行更长随访时间并考虑临床结局指标的进一步研究。
