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Published on: June 15, 2012
Design limitations of Bryan disc arthroplasty
Shee Yan Fong1, Stephan J DuPlessis, Steven Casha
1University of Calgary Spine Program, Foothills Hospital and Medical Centre, 1403 29th Street, NW Calgary, Alberta, T2N 2T9, Canada.
Summary
Bryan disc arthroplasty often results in kyphosis, decreasing cervical spine height. Careful consideration of limitations is crucial when maintaining lordosis is desired.
Area of Science:
- Spine surgery
- Orthopedics
- Neurosurgery
Background:
- Disc arthroplasty is an emerging surgical treatment for spinal degenerative disease.
- Evaluating the benefits and limitations of such procedures is essential.
Purpose of the Study:
- To investigate factors contributing to segmental kyphosis following Bryan disc replacement.
- To analyze radiographic outcomes and identify predictors of postoperative spinal alignment.
Main Methods:
- Prospective study of 10 patients undergoing single-level Bryan cervical disc arthroplasty.
- Analysis of static and dynamic lateral radiographs compared to preoperative measurements.
- Assessment of functional spine unit (FSU) height and angulation.
Main Results:
- 90% of patients developed kyphosis at the disc arthroplasty site.
- Significant kyphotic change (-7 degrees) and reduced FSU height (1.7 mm) postoperatively.
- Kyphosis correlated with reduced posterior vertebral body height and increased FSU kyphosis.
Conclusions:
- Bryan disc arthroplasty shows a tendency towards kyphosis, potentially due to intraoperative distraction and asymmetrical end plate preparation.
- Reduced FSU height results from a lack of anterior column support.
- Limitations, particularly regarding cervical lordosis maintenance, require careful consideration.
