• Christoph Mehren, Franziska Heider, Daniel Sauer, Ralph Kothe, Andreas Korge, Wolfgang Hitzl, and Karin Wuertz-Kozak.
• Schön Klinik München Harlaching, Spine Center, Munich, Germany.
• Spine. 2019 Feb 15; 44 (4): E202-E210.

Study DesignA nonrandomized, prospective, and single-center clinical trial of the ProDisc Vivo prosthesis.ObjectiveThe aim of this study was to investigate the clinical and radiological results of a refined total cervical disc replacement (cTDR), the ProDisc Vivo, with two years of follow-up (FU). The incidence of implant-related complications was recorded as a secondary outcome variable.Summary Of Background DataPrevious generations of the ProDisc artificial cervical disc replacement generate high primary stability due to keel-based designs with opening of the anterior cortex during the implantation and subsequent high rates of heterotopic ossifications.MethodsClinical outcome scores included the Neck Disability Index (NDI), Visual Analogue Scale (VAS), arm and neck pain self-assessment questionnaires. The radiological outcome included the range of motion (ROM) and the occurrence of heterotopic ossifications. The incidence of implant-related complications with new implant design was recorded as a secondary outcome variable.ResultsA total of 55 patients received a single-level treatment with the ProDisc Vivo cTDR between C3/4 and C6/7, with a follow-up rate of 78%. The clinical outcome scores improved in all parameters significantly (P = 0.0001) (NDI: 68.3 → 17.4; VAS arm: 6.3 → 1.4; VAS neck: 4.9 → 1.6). The ROM of the index-segment did not show a significant change (P = 0.26) (7.9° → 9.2°). Heterotopic ossifications at the index segment was found as grade 0 in 58%, grade 1 in 22%, grade 2 in 10%, grade 3 (with functional impairment of the prosthesis) in 7%, and grade 4 in 3% of the cases. We observed three implant-related complications (5.5%), with two implant dislocations anteriorly and one low-grade infect.ConclusioncTDR with ProDisc Vivo demonstrated a significant and sustained improvement of all clinical outcome parameters. A less invasive implantation mechanism with lower primary stability of the cTDR might be a reason for a higher dislocation rate than the keel-based previous generation ProDisc C.Level Of Evidence4.

33 keywords...

hide…