1
|
Pensado-López A, Ummarino A, Khan S, Guildford A, Allan IU, Santin M, Chevallier N, Varaillon E, Kon E, Allavena P, Torres Andón F. Synthetic peptides of IL-1Ra and HSP70 have anti-inflammatory activity on human primary monocytes and macrophages: Potential treatments for inflammatory diseases. NANOMEDICINE : NANOTECHNOLOGY, BIOLOGY, AND MEDICINE 2024; 55:102719. [PMID: 37977510 DOI: 10.1016/j.nano.2023.102719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/05/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
Chronic inflammatory diseases are increasing in developed societies, thus new anti-inflammatory approaches are needed in the clinic. Synthetic peptides complexes can be designed to mimic the activity of anti-inflammatory mediators, in order to alleviate inflammation. Here, we evaluated the anti-inflammatory efficacy of tethered peptides mimicking the interleukin-1 receptor antagonist (IL-1Ra) and the heat-shock protein 70 (HSP70). We tested their biocompatibility and anti-inflammatory activity in vitro in primary human monocytes and differentiated macrophages activated with two different stimuli: the TLR agonists (LPS + IFN-γ) or Pam3CSK4. Our results demonstrate that IL-1Ra and HSP70 synthetic peptides present a satisfactory biocompatible profile and significantly inhibit the secretion of several pro-inflammatory cytokines (IL-6, IL-8, IL-1β and TNFα). We further confirmed their anti-inflammatory activity when peptides were coated on a biocompatible material commonly employed in surgical implants. Overall, our findings support the potential use of IL-1Ra and HSP70 synthetic peptides for the treatment of inflammatory conditions.
Collapse
Affiliation(s)
- Alba Pensado-López
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy.
| | - Aldo Ummarino
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, 20089, Milan, Italy.
| | - Sophia Khan
- Tissue Click Ltd, The Knoll Business Centre, Old Shoreham Rd, Hove, BN3 7GS, UK.
| | - Anna Guildford
- Tissue Click Ltd, The Knoll Business Centre, Old Shoreham Rd, Hove, BN3 7GS, UK.
| | - Iain U Allan
- Tissue Click Ltd, The Knoll Business Centre, Old Shoreham Rd, Hove, BN3 7GS, UK.
| | - Matteo Santin
- Centre for Regenerative Medicine and Devices, School of Applied Sciences, University of Brighton, Huxley Building Lewes Road, Brighton BN 24GJ, UK.
| | - Nathalie Chevallier
- IMRB, U955, INSERM, Unite d'Ingenierie et de Therapie Cellulaire-Etablissement Français du Sang, Universite Paris-EST Créteil, 94017 Créteil, France.
| | - Elina Varaillon
- IMRB, U955, INSERM, Unite d'Ingenierie et de Therapie Cellulaire-Etablissement Français du Sang, Universite Paris-EST Créteil, 94017 Créteil, France.
| | - Elizaveta Kon
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, 20089, Milan, Italy.
| | - Paola Allavena
- IRCCS Humanitas Research Hospital, Rozzano, 20089, Milan, Italy.
| | - Fernando Torres Andón
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy; Instituto de Investigación Biomédica de A Coruña (INIBIC), Medical Oncology Unit, Complexo Hospitalario de A Coruña (CHUAC), 15006 A Coruña, Spain.
| |
Collapse
|
2
|
Boukebous B, Serfaty L, Abdelhedi O, Zoghlami M, Maillot C, Lazennec JY, Rousseau MA. The Anteroposterior Positioning of Viscoelastic Cervical Disc Prosthesis Does Not Alter the Outcomes. Int J Spine Surg 2023; 17:690-697. [PMID: 37813454 PMCID: PMC10623670 DOI: 10.14444/8533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND While first-generation articulated disc prostheses had an ideal positioning schematically as posterior as possible because of their geometrically determined center of rotation, the dogma may change for viscoelastic implants, whose center of rotation is free. Our hypothesis was to assess whether the anteroposterior positioning (APP) of a viscoelastic implant may influence the clinical or radiological outcomes at follow-up. METHODS Twenty-five patients (mean age 47 years) were evaluated, with an average follow-up of 25.9 months. The primary outcome was the implants' APP on lateral radiographs. APP between 0% and 49% meant anterior centering, 50% perfect centering, and 51% to 100% posterior centering. The cohort was divided into 2 groups: anterior positioning and posterior positioning. Measurements were performed blindly to the functional outcomes. Visual analog scale for neck pain and radicular pain and the Neck Disability Index were assessed. Range of motion was measured at the last follow-up. The C2 to C7 Cobb angle and the spinocranial angle were also measured. RESULTS The median crude offset from the vertebral endplate center was 0.4 mm (mean: 0.3 mm, Q1: -1.5 mm, Q3: 2 mm; range, -2.9 to 4 mm). The mean overall APP was 49%, 45.2% (95% CI, 43.2%-47.1%) in the anterior group, and 54.1% (95% CI, 51.4%-55.3%) in the posterior group. Fifteen patients were in the group anterior positioning and 10 in the group posterior positioning. The mean spinocranial angle was 79° preoperatively and 74° preoperatively (P = 0.04). Functional outcomes were significantly improved at the last follow-up (P < 10-4). There was no significant correlation between the APP, functional outcomes, and range of motion. CONCLUSION The APP of the CP-ESP viscoelastic disc arthroplasty does not significantly influence the clinical or radiological outcomes at follow-up. This study suggests that this type of implant tolerates greater variability in its implantation technique. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Baptiste Boukebous
- Orthopedic department, Hopitaux de Paris/Université Paris Cité, Clichy, France
- ECAMO Team, CRESS, INSERM URM 1153
| | - Lorenzo Serfaty
- Orthopedic department, Hopitaux de Paris/Université Paris Cité, Clichy, France
| | - Oussema Abdelhedi
- Orthopedic department, Hopitaux de Paris/Université Paris Cité, Clichy, France
| | - Mohamed Zoghlami
- Orthopedic department, Hopitaux de Paris/Université Paris Cité, Clichy, France
| | - Cédric Maillot
- Orthopedic department, Hopitaux de Paris/Université Paris Cité, Clichy, France
| | | | | |
Collapse
|
3
|
Jacobs CAM, Doodkorte RJP, Kamali SA, Abdelgawad AM, Ghazanfari S, Jockenhoevel S, Arts JJC, Tryfonidou MA, Meij BP, Ito K. Biomechanical evaluation of a novel biomimetic artificial intervertebral disc in canine cervical cadaveric spines. JOR Spine 2023; 6:e1251. [PMID: 37361332 PMCID: PMC10285750 DOI: 10.1002/jsp2.1251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/16/2023] [Accepted: 01/29/2023] [Indexed: 06/28/2023] Open
Abstract
Background Context Cervical disc replacement (CDR) aims to restore motion of the treated level to reduce the risk of adjacent segment disease (ASD) compared with spinal fusion. However, first-generation articulating devices are unable to mimic the complex deformation kinematics of a natural disc. Thus, a biomimetic artificial intervertebral CDR (bioAID), containing a hydroxyethylmethacrylate (HEMA)-sodium methacrylate (NaMA) hydrogel core representing the nucleus pulposus, an ultra-high-molecular-weight-polyethylene fiber jacket as annulus fibrosus, and titanium endplates with pins for primary mechanical fixation, was developed. Purpose To assess the initial biomechanical effect of the bioAID on the kinematic behavior of the canine spine, an ex vivo biomechanical study in 6-degrees-of-freedom was performed. Study Design A canine cadaveric biomechanical study. Methods Six cadaveric canine specimens (C3-C6) were tested in flexion-extension (FE), lateral bending (LB) axial rotation (AR) using a spine tester in three conditions: intact, after C4-C5 disc replacement with bioAID, and after C4-C5 interbody fusion. A hybrid protocol was used where first the intact spines were subjected to a pure moment of ±1 Nm, whereafter the treated spines were subjected to the full range of motion (ROM) of the intact condition. 3D segmental motions at all levels were measured while recording the reaction torsion. Biomechanical parameters studied included ROM, neutral zone (NZ), and intradiscal pressure (IDP) at the adjacent cranial level (C3-C4). Results The bioAID retained the sigmoid shape of the moment-rotation curves with a NZ similar to the intact condition in LB and FE. Additionally, the normalized ROMs at the bioAID-treated level were statistically equivalent to intact during FE and AR while slightly decreased in LB. At the two adjacent levels, ROMs showed similar values for the intact compared to the bioAID for FE and AR and an increase in LB. In contrast, levels adjacent to the fused segment showed an increased motion in FE and LB as compensation for the loss of motion at the treated level. The IDP at the adjacent C3-C4 level after implantation of bioAID was close to intact values. After fusion, increased IDP was found compared with intact but did not reach statistical significance. Conclusion This study indicates that the bioAID can mimic the kinematic behavior of the replaced intervertebral disc and preserves that for the adjacent levels better than fusion. As a result, CDR using the novel bioAID is a promising alternative treatment for replacing severely degenerated intervertebral discs.
Collapse
Affiliation(s)
- Celien A. M. Jacobs
- Orthopedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenNoord‐BrabantThe Netherlands
| | - Remco J. P. Doodkorte
- Department of Orthopedic Surgery, Research School CAPHRIMaastricht University Medical CenterMaastrichtLimburgThe Netherlands
| | - S. Amir Kamali
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtUtrechtThe Netherlands
| | - Abdelrahman M. Abdelgawad
- Aachen‐Maastricht Institute for Biobased Materials, Faculty of Science and EngineeringMaastricht UniversityGeleenLimburgThe Netherlands
| | - Samaneh Ghazanfari
- Aachen‐Maastricht Institute for Biobased Materials, Faculty of Science and EngineeringMaastricht UniversityGeleenLimburgThe Netherlands
| | - Stefan Jockenhoevel
- Aachen‐Maastricht Institute for Biobased Materials, Faculty of Science and EngineeringMaastricht UniversityGeleenLimburgThe Netherlands
- Department of Biohybrid and Medical Textiles (BioTex), AME – Institute of Applied Medical EngineeringHelmholtz Institute, RWTH Aachen UniversityAachenNordrhein‐WestfalenGermany
| | - J. J. Chris Arts
- Orthopedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenNoord‐BrabantThe Netherlands
- Department of Orthopedic Surgery, Research School CAPHRIMaastricht University Medical CenterMaastrichtLimburgThe Netherlands
| | - Marianna A. Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtUtrechtThe Netherlands
| | - Björn P. Meij
- Department of Clinical Sciences, Faculty of Veterinary MedicineUtrecht UniversityUtrechtUtrechtThe Netherlands
| | - Keita Ito
- Orthopedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenNoord‐BrabantThe Netherlands
| |
Collapse
|
4
|
Obid P, Rakow A, Lang GM, Marx W, Niemeyer T, Rahim T. Clinical and Radiological Outcome of Disc Arthroplasty for the Treatment of Cervical Spondylotic Myelopathy. J Pers Med 2023; 13:jpm13040592. [PMID: 37108978 PMCID: PMC10144591 DOI: 10.3390/jpm13040592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction: The aim of this study is to evaluate the clinical and radiological results of cervical disc arthroplasty (CDA) in patients with cervical spondylotic myelopathy (CSM) using the CP ESP® disc prosthesis. Materials and Methods: Prospectively collected data of 56 patients with CSM have been analyzed. The mean age at surgery was 35.6 years (range: 25–43 years). The mean follow-up was 28.2 months (range: 13–42 months). The range of motion (ROM) of the index segments, as well as upper and lower adjacent segments, was measured before surgery and at final follow-up. The C2-C7 sagittal vertical axis (SVA), C2-C7 cervical lordosis (CL), and T1 slope minus cervical lordosis (T1s-CL) were analyzed as well. Pain intensity was measured preoperatively and during follow-up using an 11-point numeric rating scale (NRS). Modified Japanese Orthopaedic Association (mJOA) score was assessed preoperatively and during follow-up for the clinical assessment of myelopathy. Surgical and implant-associated complications were analyzed as well. Results: The NRS pain score improved from a mean of 7.4 (±1.1) preoperatively to a mean of 1.5 (±0.7) at last follow-up (p < 0.001). The mJOA score improved from a mean of 13.1 (±2.8) preoperatively to a mean of 14.8 (±2.3) at last follow-up (p < 0.001). The mean ROM of the index levels increased from 5.2° (±3.0) preoperatively to 7.3° (±3.2) at last follow-up (p < 0.05). Four patients developed heterotopic ossifications during follow-up. One patient developed permanent dysphonia. Conclusions: CDA showed good clinical and radiological outcome in this cohort of young patients. The motion of index segments could be preserved. CDA may be a viable treatment option in selected patients with CSM.
Collapse
|
5
|
Yu Z, Thakolkaran P, Shea K, Stanković T. Artificial neural network supported design of a lattice-based artificial spinal disc for restoring patient-specific anisotropic behaviors. Comput Biol Med 2022. [DOI: 10.1016/j.compbiomed.2022.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
6
|
Lin H, Chang N, Mobbs R, Hui N. Comparison of in vivo kinematic and radiological parameters of three cervical disc prostheses. JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE 2022; 13:55-61. [PMID: 35386247 PMCID: PMC8978856 DOI: 10.4103/jcvjs.jcvjs_92_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/02/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: Cervical total disc replacement (CTDR) is an alternative to anterior cervical discectomy and fusion for select patients that may preserve range of motion and reduce adjacent segment disease. Various CTDR prostheses are available; however, comparative data are limited. This study aimed to compare the short-term kinematic and radiological parameters of the M6-C, Mobi-C, and the CP-ESP prostheses. Methods: This retrospective cohort study included patients treated with CTDR between March 2005 and October 2020 at a single institution. Patients were included if their follow-up assessment included lateral erect and flexion/extension radiographs. The primary outcome assessed at 3-months postoperatively was range of motion, measured by the difference in functional spinal unit angle between flexion and extension. Results: A total of 131 CTDR levels (120 patients, 46.2 ± 10.1 years, 57% male) were included. Prostheses implanted included the M6-C (n = 52), Mobi-C (n = 54), and CP-ESP (n = 25). Range of motion varied significantly (8.2° ± 4.4° vs. 10.9° ± 4.7° vs. 6.1° ± 2.7°, P < 0.001). On post hoc analysis, the Mobi-C prosthesis demonstrated a significantly greater range of motion than either the M6-C prosthesis (P = 0.003) or CP-ESP (P < 0.001). Conclusion: Although the optimal range of motion for CTDR has not been established, short-term differences in the range of motion may guide the selection of CTDR prosthesis. Further studies with longer follow-up and consideration of clinical outcome measures are necessary.
Collapse
|
7
|
Patwardhan AG, Havey RM. Biomechanics of Cervical Disc Arthroplasty Devices. Neurosurg Clin N Am 2021; 32:493-504. [PMID: 34538475 DOI: 10.1016/j.nec.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Prosthesis design has an influence on the quantity and quality of postoperative motion after cervical disc arthroplasty. Prostheses with built-in resistance to angular and translational motion may have an advantage in restoring physiologic motion. The ability of a prosthesis to work with remaining bony and soft tissues to restore motion and load-sharing is a function of the kinematic degrees of freedom DOF, axis of rotation for a given motion, and device stiffness. How these characteristics allow the prosthesis to work with the patient's anatomy will determine whether the prosthesis is successful at restoring motion and mitigating adjacent-level stresses.
Collapse
Affiliation(s)
- Avinash G Patwardhan
- Musculoskeletal Biomechanics Laboratory, Edward Hines, Jr. VA Hospital, PO Box 5000, Hines, IL, 60141 USA; Department of Orthopedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.
| | - Robert M Havey
- Musculoskeletal Biomechanics Laboratory, Edward Hines, Jr. VA Hospital, PO Box 5000, Hines, IL, 60141 USA
| |
Collapse
|
8
|
Guyer RD, Albano JL, Ohnmeiss DD. Cervical Total Disc Replacement: Novel Devices. Neurosurg Clin N Am 2021; 32:449-460. [PMID: 34538471 DOI: 10.1016/j.nec.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This article reviews the available literature for novel cervical total disc replacement devices, including ones which are available inside and outside of the United States. It includes biomechanical consideration as well as design characteristics and clinical data when available.
Collapse
Affiliation(s)
- Richard D Guyer
- Center for Disc Replacement at Texas Back Institute, 6020 W. Parker Rd. #200, Plano, TX 75093, USA.
| | - Joseph L Albano
- Texas Back Institute, 6020 W. Parker Rd. #200, Plano, TX 75093, USA
| | - Donna D Ohnmeiss
- Texas Back Institute Research Foundation, 6020 W. Parker Rd. #200, Plano, TX 75093, USA
| |
Collapse
|
9
|
Jacobs CAM, Siepe CJ, Ito K. Viscoelastic cervical total disc replacement devices: Design concepts. Spine J 2020; 20:1911-1924. [PMID: 32810609 DOI: 10.1016/j.spinee.2020.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 02/03/2023]
Abstract
Cervical disc replacement (CDR) is a motion-preserving surgical procedure for treating patients with degenerative disorders. Numerous reports of first generation CDR "ball-and-socket" articulating devices have shown satisfactory clinical results. As a result, CDR devices have been safely implemented in the surgeon's armamentarium on a global scale. However, only minor design improvements have been made over the last few years, as first generation CDRs devices were based on traditional synovial joint arthroplasty designs. As a consequence, these articulating designs have limited resemblance to the complex kinematic behavior of a natural disc. This has driven the development of deformable viscoelastic CDR devices to better mimic the biomechanical behavior of a natural disc. As a result, several viscoelastic CDR devices have been developed in recent years that vary in terms of materials, design and clinical outcomes. Since these viscoelastic CDR devices are fairly new, their weaknesses and strengths, which are related to their design characteristics, have not been well described. Therefore, this literature review discusses design related advantages and disadvantages of deformable viscoelastic CDR devices. As such, this paper can provide insight for surgeons and engineers on specific design characteristics of several viscoelastic devices and could potentially help to develop and design future implants. Eleven viscoelastic CDR devices were identified. An extensive database search on the devices' tradenames in Medline and PubMed was performed next. The devices were categorized based on common design characteristics to give an overview of both category and device specific complications and advantages. Overall, literature shows that most of these viscoelastic CDR devices can provide motion in all six degrees-of-freedom and have a variable center of rotation. Nevertheless, the viscoelastic materials used do not have an extensive history in orthopedics, so the long-term material behavior in vivo is still unknown. Although the viscoelastic devices have common benefits and risks, each specific design and category also has its own design related advantages and drawbacks that are described in this review. Altogether, viscoelastic total disc replacements seem to be a promising option for the future of cervical arthroplasty, but long-term clinical outcome is needed to confirm the advantages of mimicking the viscoelasticity of a natural disc.
Collapse
Affiliation(s)
- Celien A M Jacobs
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, De Rondom 70, 5612 AP Eindhoven, the Netherlands.
| | - Christoph J Siepe
- Schoen Clinic Munich Harlaching, Spine Center, Harlachinger Str. 51, D-81547 Munich, Germany; Spine Research Institute and Academic Teaching Hospital of the Paracelsus University Salzburg (PMU), Strubergasse 21, A-5020 Salzburg, Austria
| | - Keita Ito
- Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, De Rondom 70, 5612 AP Eindhoven, the Netherlands
| |
Collapse
|
10
|
Lazennec JY. Lumbar and cervical viscoelastic disc replacement: Concepts and current experience. World J Orthop 2020; 11:345-356. [PMID: 32904082 PMCID: PMC7448204 DOI: 10.5312/wjo.v11.i8.345] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/23/2020] [Accepted: 07/19/2020] [Indexed: 02/06/2023] Open
Abstract
The ideal lumbar and cervical discs should provide six degrees of freedom and tri-planar (three-dimensional) motion. Although all artificial discs are intended to achieve the same goals, there is considerable heterogeneity in the design of lumbar and cervical implants. The “second generation total disc replacements” are non-articulating viscoelastic implants aiming at the reconstruction of physiologic levels of shock absorption and flexural stiffness. This review aims to give an overview of the available implants detailing the concepts and the functional results experimentally and clinically. These monobloc prostheses raise new challenges concerning the choice of materials for the constitution of the viscoelastic cushion, the connection between the components of the internal structure and the metal endplates and even the bone anchoring mode. New objectives concerning the quality of movement and mobility control must be defined.
Collapse
Affiliation(s)
- Jean Yves Lazennec
- Department of Orthopaedic and Trauma Surgery, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris F-75013, France
| |
Collapse
|
11
|
Nunley PD, Coric D, Frank KA, Stone MB. Cervical Disc Arthroplasty: Current Evidence and Real-World Application. Neurosurgery 2018; 83:1087-1106. [DOI: 10.1093/neuros/nyx579] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 11/07/2017] [Indexed: 12/22/2022] Open
Affiliation(s)
| | - Domagoj Coric
- Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina
| | | | - Marcus B Stone
- Carolina Neurosurgery & Spine Associates, Charlotte, North Carolina
| |
Collapse
|
12
|
Chin KR, Lubinski JR, Zimmers KB, Sands BE, Pencle F. Clinical experience and two-year follow-up with a one-piece viscoelastic cervical total disc replacement. JOURNAL OF SPINE SURGERY (HONG KONG) 2017; 3:630-640. [PMID: 29354742 PMCID: PMC5760417 DOI: 10.21037/jss.2017.12.03] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND The purpose of this study is to present clinical outcome data from a 2-year post-market study of a viscoelastic one-piece cervical total disc replacement (TDR) in Europe. METHODS Thirty-nine patients were implanted at five surgical sites in an European post-market clinical study. Clinical outcomes included improvement of neck disability index (NDI) and visual analog scale scores for neck and arm pain from baseline to 2-year follow-up, neurological examinations, patients view on the success of surgery, complications, and subsequent surgical interventions. RESULTS Thirty patients had the Freedom® Cervical Disc (FCD) implanted at a single level, and nine patients were implanted at two adjacent levels. The population had a similar distribution of male [20] and female [19] subjects, with a mean age of 45 years. All self-administered outcome measures showed significant clinically important improvements from baseline to the 2-year follow-up. Mean preoperative NDI score improved from 48% to 20%, 13%, 8%, 6% and 4% at 6 weeks, 3, 6, 12, and 24 months, respectively. Average preoperative visual analog scale (VAS) scores of the neck, right and left arm pain intensity and frequency showed significant improvement. All neurological outcome measurements showed immediate improvement from preoperative values and continued improvement throughout 2 years follow-up. From pre-op to 24 months, neurological deficits declined in the population from 21% to 6% for reflex function, 62% to 17% for sensory function, and 38% to 3% for motor function. No patients experienced a deterioration in any measured outcomes compared with the preoperative situation. Patient satisfaction increased over 2 years post-op, with 83% of patients responding that they would "definitely" choose to have the same treatment for their neck/arm condition and another 11% responding that they would "probably" choose to have the same treatment. CONCLUSIONS The FCD performs as expected in patients with single-level and two-level degenerative disc disease.
Collapse
|