Prosthetics of Cervical Discs as an Alternative of Anterocervical Intervertebral Spodylodesis: The First Experience and Results

Chigryay M., Weber F.

Saarbruken Clinic, Saarbruken, Germany

 

The research goal was to compare outcomes in prosthetics of cervical discs and anterocervical spodylodesis on the basis of objective reduction of neurological symptoms and signs, improvement of a functional state and ensured mobility.

Material and Methods. A state of 90 cases (prosthetics of cervical discs - 30, vertebrae fixation with cages - 30, fixation with a pallacos-system - 30) was estimated in pre- and postoperative periods, then in 6 weeks, 6 months, 1 and 2 years. The estimation was based on the modified Odom scale, taking into account less marked manifestation of both symptoms and objective neurological signs, watched before operation. X-ray films were analyzed separately. It made it possible to determine a degree of mobility and to reveal displacement and/or loosening of an applied device.

Results. As for cases with prosthetics of cervical intervertebral discs, a volume of movements did not change, as compared to a preoperative level. Cases with anterocervical spondylodesis were characterized by its reduction after operation. There were no cases with displacement or loosening of an applied device.

Conclusions. Today intervertebral spondylodesis of the cervical spine is considered to result in quick degeneration of adjacent discs due to a higher load. Thus, reconstruction of an intervertebral disc with a functional prosthesis appears to have some advantages, as decompression and fixation both ensure mobility and protect adjacent discs from pathologic loads, conditioned by fusion. It is achieved by preserving physiologic mobility and kinematics.