Surgical experience with an implanted artificial cervical joint

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Object. To assess the effectiveness of Cummins' artificial cervical joint, the authors reviewed the cases of 20 patients in whom the joint had been placed.

Methods. A review of patients' medical records and reexamination of 18 patients were performed. The review of the surgical experience with the implantation of movable stainless-steel joints in 20 patients treated for cervical myelopathy (16 patients), cervical radiculopathy (three patients), and severe pain (one patient) indicated that the procedure is safe and well tolerated and does preserve cervical joint motion in most patients over an extended period of observation. To date, adjacent segmental symptomatic degenerative changes leading to further surgical treatment have been avoided. The joint has been placed in patients with advanced congenital and acquired cervical fusion and has been demonstrated to be stable, mobile, and biomechanically and biochemically compatible; it has shown no subsidence into adjacent bone. Wear debris has not occurred.

Conclusions. The use of stainless steel in the cervical spine appears to be suitable for this joint replacement design.

Article Information

Address reprint requests to: James T. Robertson, M.D., Department of Neurosurgery, University of Tennessee, 847 Monroe Avenue, Suite 427, Memphis, Tennessee 38163.

© AANS, except where prohibited by US copyright law.

Headings

Figures

  • View in gallery

    Design of the artificial joint composed of stainless steel, made individually by Mr. Colin Walker at Frenchay Hospital.

  • View in gallery

    Three x-ray films showing the artificial cervical joint at C6–7 with movement demonstrated on flexion (left) and extension (center) views; the anterior view (right) illustrates joint placement.

  • View in gallery

    Two x-ray films obtained in a patient who underwent previous fusion at C5–6 and had congenital fusion at C3–4. The artificial cervical joint can be observed at C6–7 with movement shown on flexion (left) and extension (right) views.

  • View in gallery

    Two x-ray films showing the artificial cervical joints at two levels with flexion (left) and extension (right) views. Note that the spinous process separation on the flexion view is compressed compared with the extension view.

  • View in gallery

    An x-ray film showing the artificial cervical joint at C3–4 without motion because of overdistraction of facet joints.

References

1.

Alemo-Hammad S: Use of acrylic in anterior cervical discectomy: technical note. Neurosurgery 17:94961985Alemo-Hammad S: Use of acrylic in anterior cervical discectomy: technical note. Neurosurgery 17:94–96 1985

2.

Büttner-Janz KSchellnack KZippel H: Biomechanics of the SB Charité lumbar intervertebral disc endoprosthesis. Int Orthop 13:1731761989Büttner-Janz K Schellnack K Zippel H: Biomechanics of the SB Charité lumbar intervertebral disc endoprosthesis. Int Orthop 13:173–176 1989

3.

Cloward RB: The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:6026171958Cloward RB: The anterior approach for removal of ruptured cervical disks. J Neurosurg 15:602–617 1958

4.

Edeland HG: Some additional suggestions for an intervertebral disc prosthesis. J Biomed Mat Res 23:1891989Edeland HG: Some additional suggestions for an intervertebral disc prosthesis. J Biomed Mat Res 23:189 1989

5.

Edeland HG: Suggestions for a total elasto-dynamic intervertebral disc prosthesis. Biomat Med Dev Artif Org 9:65721981Edeland HG: Suggestions for a total elasto-dynamic intervertebral disc prosthesis. Biomat Med Dev Artif Org 9:65–72 1981

6.

Fernstrom U: Arthroplasty with intercorporal endoprosthesis in herniated disc and in painful disc. Acta Chir Scand Suppl 355:1541591966Fernstrom U: Arthroplasty with intercorporal endoprosthesis in herniated disc and in painful disc. Acta Chir Scand Suppl 355:154–159 1966

7.

Froning EC inventor: Intervertebral disc prosthesis and instruments for locating the same. US patent 3 875 695. 1975Apr 8Froning EC inventor: Intervertebral disc prosthesis and instruments for locating the same. US patent 3 875 695. 1975 Apr 8

8.

Kostuik JPHedman THellier Wet al: Design of an intervertebral disc prosthesis. Spine 16 (Suppl):S256S2601991Kostuik JP Hedman T Hellier W et al: Design of an intervertebral disc prosthesis. Spine 16 (Suppl):S256–S260 1991

9.

Patil AA inventor: Artificial intervertebral disc. US patent 4 309 777. 1982Apr 8Patil AA inventor: Artificial intervertebral disc. US patent 4 309 777. 1982 Apr 8

10.

Ray CD: The artificial disc. Introduction, history and socioeconomics in Weinstein JN (ed): Clinical Efficacy and Outcome in the Diagnosis and Treatment of Low Back Pain. New York: Raven Press1992 pp 205225Ray CD: The artificial disc. Introduction history and socioeconomics in Weinstein JN (ed): Clinical Efficacy and Outcome in the Diagnosis and Treatment of Low Back Pain. New York: Raven Press 1992 pp 205–225

11.

Ray CDCorbin T inventors: Prosthetic disc and method of implanting. US patent 4 772 287. 1988Sept 20Ray CD Corbin T inventors: Prosthetic disc and method of implanting. US patent 4 772 287. 1988 Sept 20

12.

Reitz HJoubert MJ: Intractable headache and cervico-brachialgia treated by complete replacement of cervical intervertebral discs with a metal prosthesis. S Afr Med J 38:8818841964Reitz H Joubert MJ: Intractable headache and cervico-brachialgia treated by complete replacement of cervical intervertebral discs with a metal prosthesis. S Afr Med J 38:881–884 1964

13.

Steffee AD: The development and use of an artificial disk: case presentation. Camp Back Issues 2:141989Steffee AD: The development and use of an artificial disk: case presentation. Camp Back Issues 2:14 1989

14.

Urbaniak JRBright DBHopkins JE: Replacement of intervertebral disc in chimpanzees by silicone-Dacron implants: a preliminary report. J Biomed Mat Res Sympos 4:1651861973Urbaniak JR Bright DB Hopkins JE: Replacement of intervertebral disc in chimpanzees by silicone-Dacron implants: a preliminary report. J Biomed Mat Res Sympos 4:165–186 1973

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