Intermediate Results of the Prestige LP Cervical Disc Replacement Clinical and Radiological Analysis With Minimum Two-Year Follow-up

Study Design. Prospective study. Objective. Present results of Prestige LP artificial cervical disc replacement (ADR). Summary of Background Data. Motion preservation with ADR can potentially reduce adjacent segment degeneration. Methods. Forty patients with 59 Prestige LP ADR were analyzed. Cervical range of motion, Neck Disability Index, Visual Analogue, Short Form-36, Modified American Academy of Orthopedic Surgeons, and Japanese Orthopedic Association scores and radiographs were evaluated. Clinical results were compared with anterior cervical discectomy and fusion. Results. There were 21 females and 19 males. Mean age was 43.9 years. Mean follow-up was 2.9 years. Of the patients, 62.5% had single level replacement-mainly C56 level (56%); 52.5% had myelopathy and 47.5% radiculopathy; 50% of neural compression was due to herniated disc, 45% due to spondylosis, and 5% due to both. There was significant improvement in the American Academy of Orthopedic Surgeons and Visual Analogue scores (P < 0.05) at 6 months and 2 years. There was significant improvement in the Neck Disability Index from a mean of 42.2 preoperation to 16.4 at 6 months and 15.2 at 2 years (P < 0.05). The mean Japanese Orthopedic Association score improved significantly from 14.7 preoperation to 15.7 at 6 months and 15.6 at 2 years (P < 0.05). There was significant improvement in all aspects of the Short Form-36 scores except general health (P < 0.05) at 6 months and 2 years. There was no significant difference in the clinical outcomes between ADR and anterior cervical discectomy and fusion. Segmental alignment (mean 8 degrees, 14 degrees, and 13 degrees lordotic at preoperation, 6 months, and 2 years postoperation, respectively) and global alignment (mean 15.7 degrees, 16.2 degrees, and 17.3 degrees lordotic at preoperation, 6 months, and 2 years postoperation, respectively) were maintained. Dynamic radiographs showed significant segmental motion with a 6 month's mean motion of 11.1 degrees and a 2-year mean motion of 13.9 degrees (P < 0.05). Conclusion. Prestige LP ADR showed significant improvement in clinical outcomes at 2 years. It restores segmental lordosis and preserves segmental motion up to 2 years postoperation.