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Related Experiment Videos

Segmental malalignment with the Bryan cervical disc prosthesis--contributing factors.

William R Sears1, Neil Duggal, Lali H Sekhon

  • 1Department of Neurosurgery, Sydney NeuroSpine Clinic and Dalcross Private and Royal North Shore Hospitals, Sydney, Australia. thesears@bigpond.com

Journal of Spinal Disorders & Techniques
|April 7, 2007
PubMed
Summary
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The Bryan Cervical Disc prosthesis can cause a slight loss of spinal lordosis. Factors like disc space height and prosthesis angle significantly influence postoperative alignment, indicating complex surgical variables affect outcomes.

Area of Science:

  • Spine surgery
  • Orthopedic biomechanics
  • Spinal alignment

Background:

  • The Bryan Cervical Disc prosthesis is used for cervical disc replacement.
  • Previous studies indicated a median loss of functional spinal unit (FSU) lordosis post-implantation.
  • Observed variations in lordosis changes suggest influencing factors.

Purpose of the Study:

  • To identify patient and surgical variables impacting postoperative FSU malalignment.
  • To analyze factors contributing to sagittal plane alignment changes after cervical disc arthroplasty.

Main Methods:

  • Correlation analysis of 35 demographic and radiographic variables with FSU angulation changes in 67 patients (88 levels).
  • Comparison of preoperative and postoperative neutral, erect X-rays.

Related Experiment Videos

  • Multiple linear regression to determine independent predictors of malalignment.

    • Main Results:

    • Postoperative disc space height changes, prosthesis insertion angle, and bone removal amount varied significantly between surgeons and correlated with FSU alignment changes.
    • Intraoperative distraction correlated with reduced disc space height.
    • Loss of disc space height and prosthesis insertion angle were independent predictors of malalignment (R²=0.39).

    Conclusions:

    • No single factor fully explains postoperative malalignment.
    • Surgical variables, especially those affecting disc space height and annular tension, are crucial for maintaining sagittal alignment.
    • Standardized surgical techniques may still allow for variable outcomes due to multifactorial influences.