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Wear analysis of the Bryan Cervical Disc prosthesis.

Wear Analysis of the Bryan Cervical Disc Prosthesis : …

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Wear Analysis of the Bryan Cervical Disc Prosthesis

Based on this knowledge, Dr Vincent Bryan developed his total cervical disc arthroplasty device in the 1990s. Dr Goffin of Belgium implanted this prosthesis for the first time in January 2000.,,, The aim of this review is to present the Bryan® Cervical Disc System (Medtronic Sofamor Danek; Memphis, Tennesse) and its use in the treatment of degenerative disc disease. Several types of cervical disc prostheses are marketed at present.,,

Titel: Wear analysis of the Bryan Cervical Disc prosthesis

Study Design. In vitro wear testing of the Bryan® Cervical Disc prosthesis was performed in a cervical spine simulator. The biologic response was assessed in chimpanzee and goat animal models. Objective. Determine the wear characteristics of the Bryan disc. Summary of Background Data. Large joint arthroplasties fail most commonly by wear and consequent formation of particulate material, which induces an inflammatory response. Therefore, measuring the wear characteristics of the new spinal disc replacements is important. Methods. Six prosthetic assembles were tested to 10 or 40 million cycles by load and motion and 3 additional assemblies were tested by load only in a cervical spine simulator. Any debris was examined using ASTM standards. The local biologic response to the prosthesis was examined in two chimpanzees. Nine goats were used to assess the biologic response in both local and distant tissues. Arthrodesis was performed on three additional control goats that received an allograft and an anterior cervical plate. Results. Wear results: cervical spine simulators that applied the loads and motions associated with activities of daily living produced wear particulate at a rate of 1.2 mg per million cycles. Device height decreased 0.02 mm per million cycles with approximately 77% of this decrease due to gradual creep of the nucleus under the constant compressive load. Particles generated were granular in shape with a mean feret diameter of 3.9 μm. All animals tolerated placement of the Bryan disc. Wear debris was present in the periprosthetic and epidural spaces in some animals. However, no significant inflammatory response was observed. No wear material was found distant from the implant in draining lymph tissue, the liver, or the spleen. Conclusions. The Bryan disc has satisfactory wear characteristics and does not produce a significant inflammatory response.

P47. Wear analysis of retrieved Bryan cervical disc prostheses

Wear analysis of the Bryan Cervical Disc prosthesis ..

It is well understood that fusion sacrifices motion at the index level and places stresses on adjacent levels.3, 12, 13, 18, 21, 23, 25, 26, 27, 29, 50, 51, 52 The consequences of those stresses are much less understood. Adjacent level disease is likely a multifactorial process involving several disparate factors including natural history of the underlying disease process (spondylosis), surgical technique, patient selection and type of instrumentation employed. It is also well established that arthroplasty maintains motion decreases adjacent level stress compared to fusion.16, 19, 29, 30, 53, 54, 55, 56, 57 But the clinical benefits of this decreased stress remain debatable.34 It is important to differentiate between adjacent level degeneration (deterioration above or below the operative level evident on radiographic imaging) and adjacent level disease (clinically symptoms attributable to a level above or below the operative level). The only Level 1 studies to document statistically significant decrease in adjacent level disease for cervical arthroplasty are the previously discussed meta-analysis papers by McAfee37 and Upadhyaya.38 A decreased rate of adjacent deterioration from the IDE studies in favor of arthroplasty devices was reported by Coric34 (9% vs 25%), Davis10(11% vs 23%) and Vaccarro.8 Kim and associates also reported decreased degenerative change in patients treated with the Bryan artificial disc.40

Total disc arthroplasty in the cervical spine is associated with important advantages. Bryan prostheses challenge the gold-standard ACDF in the treatment of cervical degenerative discopathy associated with eventual neural impingement. Neural structures are reliably decompressed. Prostheses maintain physiological alignment, kinematics, and biomechanics of the segment. In this way, accelerated transient-segment degeneration with subsequent radiculomyelopathy is averted with high probability. Patient’s satisfaction, safety, tolerability, and longevity of the Bryan prosthesis system seem to be very acceptable. Bone graft harvest site morbidity is eliminated. Frequently, patients return to work earlier.

CarlsonWear analysis of the Bryan cervical disc ..

Bryan prostheses were exposed to in vitro cyclic fatigue testing., After 10 million cycles, the nucleus mass loss was 1.76%, which is assumed to be 50–100 times less than that in total hip arthroplasties. Nucleus height loss was on average 0.02 mm per million cycles. After 40 million moves, wear averaged 18% by weight. Therefore, contact between the shells was imminent. However, in vitro decay is estimated to be significantly higher than in vivo decay (probably 5–10 times). Under the assumption that 1 million moves occur during 1 year with normal daily activities, the Bryan prosthesis is (optimistically) expected to be functional for more than 40 years. In animal studies, polymer wear particles had a diameter of 3.9 μm on average (most of them in the range of 1–5 μm)., There was no debris dissemination into distant organs (lymph node, liver, spleen), penetration of the dura mater, accumulation of metal ion in body fluids, or significant inflammatory response by activation of various cytokines, macrophages, osteoclasts, or other cells.,, In contrast to large joint arthroplasties and metal-on-metal prostheses, Bryan discs obviously do not induce metallic debris formation.,, In a recent study on explanted devices, no case of device fracture, polymer oxidation, or metal corrosion was noted.

Stress analysis of the interface between cervical vertebrae end plates and the Bryan, Prestige LP, and ProDisc-C cervical disc prostheses: an in vivo imagebased finite element study.

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  • Wear analysis of the Bryan Cervical Disc prosthesis.

    Study Design. In vitro wear testing of the Bryan® Cervical Disc prosthesis was performed in a cervi

  • Kinematic Analysis of the Bryan Cervical Disc Prosthesis

    | In vitro wear testing of the Bryan Cervical Disc prosthesis was performed in a cervical spine simulator

  • Wear analysis of the Bryan Cervical Disc prosthesis

    On Sep 1, 2004 Paul Anderson (and others) published: P47. Wear analysis of retrieved Bryan cervical disc prostheses

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Wear analysis of the Bryan cervical disc ..

Total disc arthroplasty is a new option in the treatment of cervical degenerative disc disease. Several types of cervical disc prostheses currently challenge the gold-standard discectomy and fusion procedures. This review describes the Bryan Cervical Disc System and presents the Bryan prosthesis, its indications, surgical technique, complications, and outcomes, as given in the literature.

Wear analysis of the Bryan Cervical Disc ..

Abstract
INTRODUCTION: Early results have indicated that the Bryan cervical total disc replacement (TDR) favorably compares to anterior cervical decompression and fusion, while it is associated with fewer complications and higher levels of satisfaction. In this study, we sought to prospectively report the midterm outcomes of the Bryan TDR.
PATIENTS AND METHODS: A total of 20 patients had performed their 4-year follow-up visit and had been assessed clinically and radiologically. Clinical outcomes (JOA, VAS, NDI, SF-36) and ROM measurements were investigated preoperatively and at 1 and 6 months, and 1, 2 and 4 years after operation. Complications were also investigated. Occurrences of heterotopic ossifications (HOs) and adjacent-level degeneration (ALD) radiographic changes were detected from 4-year follow-up X-rays.
RESULTS: The mean JOA score, VAS score for arm and neck, NDI score and SF-36 score for PCS and MCS were reduced significantly at each postoperative time point when compared with the preoperative condition. The range of movement of the cervical spine, functional spinal unit, treated segment and the adjacent segment temporarily decreased at the early assessment, but all recovered to preoperative levels over a 6-month to 4-year time period. HO was evident in 6 of the 23 operated segments, which did not restrict the movement of the prosthesis. No obvious ALD was found on MRI. There were no cases of prosthesis migration, subsidence, loosening or wear.
CONCLUSION: The midterm outcomes demonstrated that the Bryan TDR maintains favorable clinical and radiological results, with preservation of movement and satisfactory clinical outcome. There were no serious complications or cases of prosthetic wear or failure. The long-term benefits are yet to be examined.

Wear analysis of retrieved Bryan cervical disc prostheses

Artificial cervical intervertebral disc prosthesis does not show obvious advantage in the follow-up. The time of the follow-up is short. Longer follow-up is needed to determine if there is some advantage of artificial cervical intervertebral disc prosthesis compared with interbody fusion. At the same time,it has its own complications as a kind of artificial joint, such as prosthesis wear and aseptic loosening.

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