title: Five-year results of cervical disc prostheses in the SWISSspine registry.
abstract: BACKGROUND
  The Swiss Federal Office of Public Health demanded a nationwide HTA-registry for cervical total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISSspine registry is to generate evidence about the safety and efficiency of cervical TDA.
  
  
  METHODS
  Three hundred thirty-two cases treated between 3.2005 and 6.2006 who were eligible for 5 years follow-ups were included in the study. Follow-up rates for 3-6 months, 1, 2 and 5 years were 84.6, 74.4, 50.6 and 64.8 %, respectively. Outcome measures were neck and arm pain, medication, quality of life, intraoperative and postoperative complication and revision rates. In addition, segmental mobility, ossification, adjacent and distant segment degeneration were analyzed at the 5-year follow-up.
  
  
  RESULTS
  There was significant, clinically relevant and lasting reduction of neck (preop/postop 60/21 VAS points) and arm pain (preop/postop VAS 67/17) and a consequently decreased analgesics consumption and quality of life improvement (preop/postop 0.39/0.82 EQ-5D points) until the 5-year follow-up. The rates for intraoperative and early postoperative complications were 0.6 and 7.2 %, respectively. In 0.6 % an early and in 3.9 % a late revision surgery was performed. At the 5-year follow-up, the average range of motion of the mobile segments (88.2 %) was 10.2°. In 40.7 % of the patients osteophytes at least potentially affecting range of motion were seen.
  
  
  CONCLUSIONS
  Cervical TDA appeared as safe and efficient in long-term pain alleviation, consequent reduction of pain killer consumption and in improvement of quality of life. The improvement is stable over the 5 years postoperative period. The vast majority of treated segments remained mobile after 5 years, although 40.7 % of patients showed osteophytes.
authors.affiliation: Institute for Evaluative Research in Orthopedic Surgery, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland. emin.aghayev@memcenter.unibe.ch
authors.forename: Emin
authors.initials: E
authors.lastname: Aghayev
authors.forename: Christian
authors.initials: C
authors.lastname: Bärlocher
authors.forename: Friedrich
authors.initials: F
authors.lastname: Sgier
authors.forename: Mustafa
authors.initials: M
authors.lastname: Hasdemir
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Steinsiepe
authors.forename: Frank
authors.initials: F
authors.lastname: Wernli
authors.forename: François
authors.initials: F
authors.lastname: Porchet
authors.forename: Oliver
authors.initials: O
authors.lastname: Hausmann
authors.forename: Aymen
authors.initials: A
authors.lastname: Ramadan
authors.forename: Gianluca
authors.initials: G
authors.lastname: Maestretti
authors.forename: Uwe
authors.initials: U
authors.lastname: Ebeling
authors.forename: Michal
authors.initials: M
authors.lastname: Neukamp
authors.forename: Christoph
authors.initials: C
authors.lastname: Röder
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000209:etiology; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012042:Registries; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D059145:Total Disc Replacement / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome