Risk Factors for Cervical Disc Arthroplasty Subsidence with Bryan Disc-A Retrospective Observational Analysis

: Cervical disc arthroplasty (CDA) is currently used instead of fusion to preserve cervical spine motion. Cervical implant subsidence is a potential complication after CDA. : Radiological measurements were recorded via patient anteroposterior and lateral radiographs in the neutral position. Subsiden...

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Bibliographic Details
Published in:Journal of clinical medicine 2024-03, Vol.13 (6), p.1589
Main Authors: Lee, Cheng-Ying, Tung, Kuan-Kai, Tsou, Hsi-Kai, Chen, Wen-Hsien, Tzeng, Chung-Yuh, Lin, Ruei-Hong, Chen, Tse-Yu, Huang, Chih-Wei, Kao, Ting-Hsien
Format: Article
Language:English
Subjects:
Arthroplasty
Back surgery
Complications
Complications and side effects
Health aspects
Joint surgery
Medical research
Medicine, Experimental
Orthopedic implants
Osteoporosis
Patients
Regression analysis
Risk factors
Spine
Surgery
Titanium alloys
Transplants & implants
Variables
Variance analysis
Vertebrae
Vertebrae, Cervical
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Summary:: Cervical disc arthroplasty (CDA) is currently used instead of fusion to preserve cervical spine motion. Cervical implant subsidence is a potential complication after CDA. : Radiological measurements were recorded via patient anteroposterior and lateral radiographs in the neutral position. Subsidence was defined as a decrease of 3 mm or more in functional spinal unit height (FSUH) from which was measured on a post-operative (OP) radiograph. : This study included 104 patients who underwent 153 CDA levels with the Bryan Disc. Approximately one-quarter of the implants (22.9%) showed subsidence. Binary logistic regression analysis indicated that pre-OP mean disc height (DH) was identified as an independent risk factor for subsidence in multivariate analysis (0.151, 95% Confidence Interval 0-0.073, = 0.018). Receiver operating characteristic curve analysis (area under the curve = 0.852, sensitivity 84.7%, specificity 77.1%) revealed a cut-off value of 4.48 mm for pre-OP Mean-DH in the risk for implant subsidence. : In this study, the subsidence rate significantly increased when the implants were oversized beyond a pre-OP Mean-DH of approximately >4 mm. Moreover, the implant subsidence incidence was higher than that reported in previous studies. This is possibly due to endplate over-preparation or disc space over-distraction during placement at the same height as the Bryan Disc (8.5 mm).
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm13061589