Asian Spine J.  2017 Dec;11(6):943-950. 10.4184/asj.2017.11.6.943.

Anterior Longitudinal Ligament Reconstruction to Reduce Hypermobility of Cervical and Lumbar Disc Arthroplasty

• Mobbs RJ
• Li JX
• Phan K

• KMID: 2397633
• DOI: http://doi.org/10.4184/asj.2017.11.6.943

Abstract

STUDY DESIGN: Retrospective case series PURPOSE: This study aims to present the early clinical and radiological outcomes of anterior longitudinal ligament (ALL) reconstruction following disc arthroplasty. OVERVIEW OF LITERATURE: Although cervical and lumbar disc arthroplasty have entered the clinical setting, there are still concerns regarding the short and long term complications arising from hypermobility of current prosthesis designs. Reconstruction of the ALL is a potential solution to disc arthroplasty hypermobility.
METHODS
ALL reconstruction following disc arthroplasty have been performed by the senior author over a 24 month period. Ligament replacements used include allograft and synthetic, ligament advanced reinforcement system (LARS) ligaments. Methods of fixation used include titanium staples, bone anchors and suture fixation. Radiological follow-up pre- and postoperative Oswestry disability index, Neck Disability Index, Patient Satisfaction index scores were recorded on all patients.
RESULTS
A total of 18 ALL reconstructions were performed. There have been no cases of early complications, revision surgery for recurrent symptoms or implant failure. Of the 6 patients receiving a minimum of 15 months follow-up, 4 patients received an allograft, 2 patients received the LARS ligament. Favourable, postoperative clinical and radiographic outcomes have been demonstrated.
CONCLUSIONS
ALL reconstruction following cervical and lumbar disc arthroplasty is a promising solution to addressing non-physiological kinematics of current disc arthroplasty devices. Randomized, controlled studies with larger study samples and long-term follow-up are required to establish these conclusions.

Keyword

Longitudinal ligaments; Lumbar vertebrae; Cervical vertebrae; Spondylosis; Arthroplasty

MeSH Terms

Allografts
Arthroplasty*
Biomechanical Phenomena
Cervical Vertebrae
Female
Follow-Up Studies
Humans
Ligaments
Longitudinal Ligaments*
Lumbar Vertebrae
Neck
Patient Satisfaction
Prosthesis Design
Retrospective Studies
Spondylosis
Suture Anchors
Sutures
Titanium
Titanium