Abstract

OLIVEIRA, Vânia et al. Há alguma diferença entre as próteses de disco cervicais?. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.3, pp.349-355. ISSN 1646-2122.

Aim: cervical arthroplasty in degenerative disc disease has emerged as an alternative to anterior arthrodesis in order to eliminate the "adjacent level disease". The prosthetic discs have different materials, design, technique and mobility. The authors proposed to evaluate pain, dysfunction and associated complications in order to compare the effectiveness of different disc prostheses. Material and Methods: cervical disc prostheses performed from 2004 to 2010 were retrospectively reviewed in a total of 22 patients with 26 implants.  The five Baguera® patients results were compared to 14 Prestige®, 4 PCM® and 3 Bryan® prostheses. The visual analogue pain scale (VAS) and Neck Disability Index (NDI) were used. Static and dynamic radiographs were evaluated to determine mobility and degenerative changes. Results: The average follow-up of 5 Baguera® prostheses was 20.2±13.7 months and the remaining 21 implants was 55.2±15.8 months (p=0.02). The assessment of pain was not significantly different. The Baguera® disc presents significant superiority in functional mobility (p=0.045), postoperative NDI (p=0.009) and overall NDI improvement (p=0.01). Comparing patients with null/mild dysfunction to severe/complete disability, Baguera® prosthesis has significant advantage over the other three prostheses (p=0.04). Complications occurred in 4 (9.5%) patients of the mix group, requiring 2 re-interventions, and 2 patients presented heterotopic ossification grade II/III with total loss of prosthesis mobility. Conclusion: The Baguera® disc presents superior mobility and function, and despite the different followup there were no complications. The other 3 prosthesis had complications and loss of mobility. Long-term results will determine whether the theoretical advantages still translate into clinical benefits.

Keywords : Cervical arthroplasty; degenerative discopathy; disc herniation; adjacent level disease; cervical disc prosthesis; Bryan®; PCM®; Prestige®; Baguera®.

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