Bone loss of the superior adjacent vertebral body immediately posterior to the anterior flange of Bryan cervical disc
Bone loss of the superior adjacent vertebral body immediately posterior to the anterior flange of Bryan cervical disc
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DOI：
10.1007/s00586-015-3849-6
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发表时间：
2015-12-01
影响因子：
2.8
通讯作者：
Han, In Bo
中科院分区：
文献类型：
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作者：
Kim, Sang Hyun;Chung, Young Sun;Han, In Bo
之前的报告均未提及Bryan颈椎间盘（Medtronic Sofamor Danek，孟菲斯，TN，USA）前缘后方紧邻的上级相邻椎骨的骨丢失，这在防止器械后移方面发挥着重要作用。作者回顾性分析了37例Bryan颈椎间盘置换术后颈椎前路全椎间盘置换术（TDR）后上级相邻椎体后缘骨丢失的临床资料。在术后1、3、6、12、24和36个月以及末次随访时收集临床和影像学结局数据，随访时间范围为42至113个月（平均60.1个月）。临床评估包括视觉模拟量表和颈部残疾指数，影像学评估包括测量脊柱功能单位的屈曲和伸展运动范围，并确定影像学变化，如骨丢失。Bryan TDR显示了良好的中期临床和影像学结局。然而，有趣的是，在3个月（n = 2）和6个月（n = 1）时，共3例患者在紧邻上级相邻椎骨的TDR凸缘后方观察到骨丢失。虽然骨丢失增加到6个月，这并没有进展，并没有退化的临床和影像学结果发生在最后一次follow.Bone丢失紧接在后面的前TDR法兰上的上级相邻椎骨可能发生在术后早期，由于可能的应力遮挡效应。然而，在最后一次随访时，它并没有导致临床变化或移植失败率增加。长期随访研究是强制性的，以评估骨丢失的长期影响。
No previous reports have mentioned bone loss of the superior adjacent vertebra immediately posterior to the anterior flange of Bryan cervical disc (Medtronic Sofamor Danek, Memphis, TN, USA), which plays a central role to prevent posterior migration of the device. The purpose of this study is to describe a new potential complication, bone loss immediately posterior to the anterior total disc replacement (TDR) flange on the superior adjacent vertebra following the Bryan cervical TDR and to discuss the possible mechanism.The authors retrospectively reviewed 37 patients undergoing cervical TDR with the Bryan cervical disc. The clinical and radiological outcome data were collected at 1, 3, 6, 12, 24, and 36 months postoperatively, and at last follow-up, which ranged from 42 to 113 moths (average, 60.1 months). Clinical evaluation included the visual analog scale and neck disability index, and the radiographic evaluation included measurements of the functional spinal unit range of motion on flexion and extension and identification of radiographic changes such as bone loss.The Bryan TDR showed good mid-term clinical and radiological outcomes. Interestingly, however, bone loss was noted immediately posterior to the TDR flange on superior adjacent vertebra in 3 total patients; at 3 months (n = 2) and 6 months (n = 1). Although the bone loss was increased up to 6 months, this did not progress and no degradation of clinical and radiological outcomes occurred at last follow-up.Bone loss immediately posterior to the anterior TDR flange on the superior adjacent vertebra can occur in the early postoperative period due to possibly stress shielding effect. However, it did not result in clinical changes or increased rates of graft failure at last follow-up. A long-term follow-up study is mandatory to evaluate the long-term effects of the bone loss.