title: Artificial cervical disc replacement with the Prestige-LP prosthesis for the treatment of non-contiguous 2-level cervical degenerative disc disease: A minimum 24-month follow-up.
abstract: OBJECTIVE
  We describe the features of non-contiguous 2-level cervical degenerative disc disease (NCDDD), investigate the safety and feasibility of artificial cervical disc replacement (ACDR) for the treatment of NCDDD, and expect that our study will provide spine surgeons with an alternative procedure for NCDDD.
  
  
  METHODS
  Twenty-five patients with NCDDD received ACDR with a Prestige-LP prosthesis. Clinical outcomes were evaluated using the 36-Short Form (SF-36, Mental Component Summary [MCS] and Physical Component Summary [PCS]), Visual Analog Scale (VAS), Japanese Orthopedic Association (JOA), and Neck Disability Index (NDI) scores. Radiographic evaluations included cervical lordosis (CL), range of motion (ROM), and disc height (DH). Data regarding complications were collected as well.
  
  
  RESULTS
  The mean follow-up period was 32.24 months. Clinical outcomes, including SF-36 MCS and PCS, VAS, JOA, and NDI scores significantly improved at the 24-month follow-up (p<0.05). There were no significant differences in CL and ROM at the 24-month follow-up (p>0.05). Although there was a significant difference between the before and 3-month follow-up (p<0.05), the ROM of the intermediate segment (IS) showed a tendency of returning to the preoperative state. The DH of the IS was maintained at each measurement while the DH of the upper and lower operated segments significantly increased at the 24-month follow-up (p<0.05). One patient, whose prosthesis remained mobile at the last follow-up, showed evidence of heterotopic ossification (HO).
  
  
  CONCLUSIONS
  ACDR with the Prestige-LP prosthesis is a safe and feasible alternative procedure for treatment of NCDDD. In the future, a large-sample, prospective randomized controlled study with long-term follow-up will be needed to further demonstrate noncontiguous ACDR as an optimal surgical option for NCDDD.
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China.
authors.forename: Tingkui
authors.initials: T
authors.lastname: Wu
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China.
authors.forename: Beiyu
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Ding
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Meng
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China.
authors.forename: Jigang
authors.initials: J
authors.lastname: Lou
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd., Sichuan 610041, China. Electronic address: dr.liuhao6304@hotmail.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D019736:Prostheses and Implants; D059145:Total Disc Replacement / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods
keywords: Artificial cervical disc replacement; Intermediated segment; Noncontiguous; Prestige-LP prosthesis; Radiographic outcomes; Skip cervical degenerative disc disease