Cervical disc arthroplasty with Prestige-LP for the treatment of contiguous 2-level cervical degenerative disc disease: 5-year follow-up results

The objective of this study is to present the long-term results and to evaluate the safety and effectiveness of the Prestige-LP cervical disc replacement in treatment of patients with symptomatic 2-level cervical degenerative disc disease. Twenty-four patients with 48 Prestige-LP disc were analyzed before surgery and at 1 week, 3 months, 6 months, 12 months, 24 months, and 60 months after surgery. Clinical assessments included 36-Short Form (SF-36), Japanese Orthopedic Assessment (JOA), visual analog scale (VAS), and Neck Disability Index (NDI) scores. Radiographic assessments included cervical lordosis (CL), disc height (DH), range of motion (ROM) of the total cervical spine, functional spinal unit (FSU) as well as upper and lower operated segment. Complications at the 5-year follow-up were collected as well. Mean follow-up period was 64.22 months. There was clinical improvement in terms of SF-36, JOA, NDI, and VAS from the preoperative to the final follow-up (P < .05). Overall, ROM of the total cervical spine, FSU, and upper and lower operated segment were maintained during the follow-up. Statistically significant (P < .05) improvements in the trend of CL and DH were noted at the follow-up. Eight patients were observed an appearance of heterotopic ossification at the 5-year follow-up, with 6 patients appeared at Class II and 2 patients at Class III. Adjacent segment degeneration assessed by radiographic evidence was found in 2 patients. Two-level cervical disc arthroplasty with Prestige-LP showed significant improvement in clinical outcomes at 5 years. It not only effectively preserves the motion of both total cervical spine and operated segments, but also restores normal CL and DH up to 5 years postoperation.