The footprint mismatch of cervical disc arthroplasty comes from degenerative factor besides ethnic factor

Sci Rep. 2024 Sep 5;14(1):20673. doi: 10.1038/s41598-024-71786-5.

Abstract

A mismatch in footprints of cervical total disc arthroplasty (CTDA) implants occasionally occurred in Asian population and it had been attributed solely to ethnic factor. Yet, cervical degeneration process may play a role. Our purpose was to compare the cervical vertebra morphometric data with and without degeneration. The study included patients with CT scans of cervical spine from our hospital between January, 2019, and September, 2021. The total cervical degenerative index (TCDI) of each patient were collected by adding CDI score for 5 disc-levels. Patients were categorized into normal (TCDI 0-5) and degeneration groups (TCDI 6-60). Various measurements of the C3-C7 vertebral body and endplate were taken. Forty-nine patients in the normal group and 55 in the degeneration group were included. No significant difference was noted in gender, BH, BW, or BMI except age and TCDI (p < .001). During degeneration, disproportional endplate size changes were observed, with an increment ratio of 12-20% in the anteroposterior and 5-17% in the mediolateral plane throughout C3-C7, while vertebral body height remained constant. In conclusion, degeneration process, besides ethnic factor, causes the endplate size and shape mismatch. This information can help spine surgeon choose appropriate implants in CTDA surgery.

Keywords: Cervical degeneration index; Cervical spine; Degenerative change; Spinal anatomy; Total disc arthroplasty; Vertebral body.

MeSH terms

  • Adult
  • Aged
  • Cervical Vertebrae* / diagnostic imaging
  • Cervical Vertebrae* / surgery
  • Ethnicity
  • Female
  • Humans
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / pathology
  • Intervertebral Disc / surgery
  • Intervertebral Disc Degeneration* / diagnostic imaging
  • Intervertebral Disc Degeneration* / surgery
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed
  • Total Disc Replacement* / methods