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Published on: July 15, 2021
Cervical hybrid arthroplasty with 2 unique fusion techniques
Mario J Cardoso1, Audra Mendelsohn, Michael K Rosner
1Neurosurgery Service, Walter Reed Army Medical Center, Washington, DC 20307, USA. mtcardoso@comcast.net
Journal of Neurosurgery. Spine
|April 5, 2011
Summary
Cervical hybrid arthroplasty using the Prestige ST disc offers a safe alternative to multilevel fusion for radiculopathy and myelopathy. This technique demonstrated effective outcomes with no major complications observed during the study period.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Biomedical engineering
Background:
- Multilevel cervical arthroplasty with the Prestige ST disc can be challenging.
- A hybrid technique combining total disc replacements (TDRs) and fusions presents an alternative.
- Evaluating the safety and radiological outcomes of this hybrid approach is crucial.
Purpose of the Study:
- To review the safety and radiological outcomes of cervical hybrid arthroplasty using the Prestige ST disc.
- To assess the efficacy of combining Prestige ST TDRs with two distinct fusion techniques.
- To determine if this hybrid approach is a viable alternative to multilevel fusion.
Main Methods:
- Retrospective review of 31 patients who underwent hybrid cervical arthroplasty with Prestige ST discs between 2007 and 2009.
- Hybrid constructs included TDR-anterior cervical decompression and fusion (ACDF) or TDR-ACDF-TDR.
- Fusion levels utilized either a Mystique resorbable plate/graft system or a Prevail stand-alone interbody spacer.
- Radiographic evaluation of cervical lordosis, range of motion, and complications (adjacent-level disease, pseudarthrosis).
- Clinical chart review for surgical complications.
Main Results:
- No significant difference in preoperative versus postoperative cervical lordosis was observed (p = 0.48).
- A significant decrease in range of motion was noted (50.0° to 38.9°, p = 0.003).
- No instances of implant complications, progressive kyphosis, heterotopic bone, pseudarthrosis, or symptomatic adjacent-level disease occurred.
- Transient dysphagia and vocal cord paralysis were reported in a small number of patients, resolving by 3 months.
Conclusions:
- Cervical hybrid arthroplasty with the Prestige ST disc, Mystique, or Prevail devices is a safe and effective option.
- This technique serves as a viable alternative to multilevel fusion for managing cervical radiculopathy and myelopathy.
- The study supports the use of hybrid arthroplasty for specific cervical spine conditions.
