Cervical Disc Arthroplasty with a Semi-constrained Implant : Clinical and Radiological Results of a 10 Years Follow-up Multicentric European Study

Introduction: Even after two decades, functional results and long-term safety of cervical arthroplasty remains under-reported. We evaluated long-term safety, mobility, and complications related to the use of the the Baguera®C prosthesis, a semi-constrained implant, over a 10 years post-operative period.

Methods: Four centers prospectively studied 91 patients treated by cervical arthroplasty. 113 prostheses were implanted (50 one-level, 44 two-level and 19 hybrid constructs). After 10 years, patients were assessed for complications, and evaluated clinically, neurologically, with NDI and SF12 questionnaires and by independent radiologists for ROM, HO and adjacent level degeneration

Results: No migration, loss of fixation, subsidence, or implant fracture were observed. The same level reoperation rate was 1%. 82.7 % of the patients were pain free. Motor function was normal for 98.8% and sensory examination for 96.3%. NDI showed an average functional disability of 17.58% at 10 years, stable between the 5 and 10 years, 26% lower than the preoperative value. SF-12 Physical and Mental scores reached values close to normal health. The average treated level ROM was 7.4°. Motion was preserved in 86.6%. ROM decreased between 2 years (94.2%) and 5 years (82.8%) post-surgery, but was stable between the 5 and 10y FU (83%). Patients over 50 did not show worse ROM results. Grade II and III HO were observed in respectively 53.7% and 31.7%, but with preserved motion. Fusion/lack of motion was seen in 13.4%. The adjacent level (upper) preoperative disc height of 4.3 mm remained stable at 4.4 and 4.2 mm respectively at 5 and 10 years.

Conclusion : This 10-year follow-up of arthroplasty patients treated with Baguera®C prostheses shows excellent safety and functional results, low complications, preserved motion in 86.6%, with a 7.4° ROM. Pain free patients reached 82.7% . HO, although common, did not hinder motion. Adjacent disc height was preserved confirming some adjacent level protection.