Cervical Disc Replacement for Spondylotic Myeloradiculopathy.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Cervical disc replacement is an emerging surgical technique for treating cervical disc prolapse.
• This prospective study evaluated the Bryan cervical disc prosthesis for cervical disc prolapse with myeloradiculopathy.

Purpose of the Study:

• To assess the efficacy of the Bryan cervical disc prosthesis in relieving neurological symptoms and signs.
• To evaluate spinal stability and range of motion after cervical disc replacement.
• To determine the outcomes of Bryan cervical disc replacement in patients with cervical disc prolapse and myeloradiculopathy.

Main Methods:

• Twenty patients (21-50 years) with degenerative cervical disc prolapse (C3-C7) and myeloradiculopathy underwent Bryan cervical disc replacement.
• Exclusion criteria included facet joint arthropathy, unstable spine, trauma, tumor, osteoporosis, and infection.
• Neurological deficit was graded using Nurick's grading, and outcomes were assessed using modified Odom's criteria at 2, 6, 12, and 24 months post-surgery.

Main Results:

• Excellent outcomes (80%) and good outcomes (20%) were observed based on modified Odom's criteria.
• Significant improvement in neck pain, brachialgia, radiculopathy, and myelopathy was noted.
• Radiological assessment confirmed maintenance of spinal motion and no device migration or displacement.

Conclusions:

• Bryan cervical disc replacement is a promising technology for single-level cervical disc prolapse with myeloradiculopathy.
• The procedure demonstrated good to excellent neurological improvement and maintained spinal motion.
• Further studies with longer follow-up and postoperative MRI are recommended to evaluate adjacent disc health.