Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2021; 9(16): 3869-3879
Published online Jun 6, 2021. doi: 10.12998/wjcc.v9.i16.3869
Clinical and radiological outcomes of dynamic cervical implant arthroplasty: A 5-year follow-up
Li Zou, Xin Rong, Xi-Jiao Liu, Hao Liu
Li Zou, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Xin Rong, Hao Liu, Department of Orthopedics, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Xi-Jiao Liu, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zou L and Rong X analyzed and interpreted the data and wrote the manuscript; Zou L and Liu XJ collected the data; Liu H designed this study and revised the article.
Institutional review board statement: This study was approved by the biomedical ethics committee of West China Hospital.
Informed consent statement: The informed consent was waived.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao Liu, MD, PhD, Professor, Department of Orthopedics, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. liuhao6304@126.com
Received: December 28, 2020
Peer-review started: December 28, 2020
First decision: January 17, 2021
Revised: January 30, 2021
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: June 6, 2021
Processing time: 136 Days and 17.8 Hours
Abstract
BACKGROUND

Dynamic cervical implant (DCI) stabilization has been reported to have satisfactory clinical and radiological results with short- and mid-term follow-up in the treatment of cervical degenerative disc disease. However, few reports about the clinical and radiological outcome with more than 5-year follow-up exist.

AIM

To investigate the long-term clinical and radiological results of DCI arthroplasty.

METHODS

A total of 40 patients who received DCI arthroplasty were consecutively reviewed from May 2010 to August 2015. Visual analogue scale (VAS), neck disability index (NDI) score, Japanese Orthopaedic Association (JOA) score, and SF-36 items were used to assess neural function rehabilitation. Static and dynamic radiographs and 3-dimentional computed tomography were used to evaluate the radiological outcomes.

RESULTS

The scores of neck/arm VAS, NDI, JOA, and 8-dimensions of SF-36 were significantly improved at the 1-mo follow-up (P < 0.05) and maintained until the last follow-up (P < 0.05). The range of motion (ROM) of C2-C7, functional spinal unit (FSU), upper/lower adjacent level, C2-C7 lateral bending, and FSU lateral bending decreased at the 1-mo follow-up (P < 0.05), whereas they increased to the preoperative level at the later follow-up intervals (P > 0.05), except the ROM of FSU lateral bending (P < 0.05). The C2-C7 alignment and FSU angle kept more lordotic at the last follow-up (P < 0.05). The intervertebral height increased significantly at the 1-mo follow-up (P < 0.05) and decreased at later follow-ups (P > 0.05). At the last follow-up, 12 (26.1%) segments developed heterotopic ossification.

CONCLUSION

DCI arthroplasty is a safe and effective non-fusion technique to treat cervical degenerative disc disease in long-term follow-up.

Keywords: Dynamic cervical implant; Cervical arthroplasty; Cervical disc degeneration; Clinical outcomes; Radiological outcomes; Range of motion

Core Tip: Dynamic cervical implant (DCI) stabilization has been reported to have satisfactory clinical and radiological results with short- and mid-term follow-up in the treatment of cervical degenerative disc disease. This is a 5-year follow-up study to investigate long-term results of DCI arthroplasty. The results showed the patients’ clinical results were significantly improved at the last follow-up. The functional spinal unit lateral bending was limited, the segmental flexion-extension range of motion could be partially preserved, and the range of motion at adjacent level could be maintained after DCI arthroplasty. We believe that DCI arthroplasty is a safe and effective non-fusion technique to treat cervical degenerative disc disease.