A comparative clinical study between 3D-printed and Prestige LP artificial discs for single-level cervical spondylosis: a cohort study
Authors: Zhang Xiaobo , Gao Zilin , Yao Xin , Xu Zhengwei , Hao Dingjun 
Published: August 2024

Abstract

Background: Prestige discs are commonly utilized in cervical disc replacement (CDR); however, they frequently necessitate endplate polishing and exhibit suboptimal "anatomical bionic" properties.
Objective: To compare the clinical efficacy of3D-printed discs and Prestige LP in the treatment of cervical spondylosis.
Methods: This retrospective study analyzed 71 patients with single-level cervical spondylosis treated between January 2020 and December 2022 at Xi'an XX Hospital. Patients were categorized into either the 3D-printed disc or Prestige LP group based on the type of artificial disc used, with 35 patients in the 3D-printed group and 36 in the Prestige LP group. The data collected included patient demographics (age), surgical details (operation time, intraoperative blood loss), clinical outcomes assessed by the visual analog scale (VAS), neck disability index(NDI), and Japanese Orthopedic Association (JOA) score, and radiological evaluations for prosthesis displacement, sinking, heterotopic ossification (HO), and anterior bone loss (ABL). The average ages of patients in the 3D-printed and Prestige group were 47.09 ± 12.71 years and 44.11 ± 9.11 years, respectively (P =0.260). The average follow-up timesfor the 3D-printed and Prestige LP groups were 29.11 ± 5.06 months and 30.44 ± 5.06 months, respectively (P = 0.272). The operation times were 87.34 ± 19.91 minutes and 92.86 ± 23.37 minutes, respectively (P = 0.289), with blood losses of 90.57 ± 45.63 ml and 95.56 ± 51.29 ml, respectively (P = 0.667). In the 3D-printed group, the preoperative VAS score averaged 5.40 ± 1.38, the JOA score averaged 12.63 ± 1.44, and the NDI averaged 28.49 ± 6.16. At the last follow-up, the VAS score decreased to 1.46 ± 0.70, the NDI decreased to 7.54 ± 2.75, and the JOA score increased to 15.57 ± 1.12. In the Prestige group, the preoperative VAS score averaged 5.31 ± 1.51, the NDI averaged 25.97 ± 9.34, and the JOA averaged 12.92 ± 1.13. The last follow-up assessments revealed a VAS score of 1.39 ± 0.80, an NDI of 7.64 ± 5.94, and a JOA score of 15.94 ± 1.04. Regarding clinical efficacy, both groups demonstrated significant improvements, with no significant differences in VAS score (P = 0.704), NDI score (P = 0.931), or JOA score (P = 0.150) at the postoperative follow-up. In terms of imaging outcomes, the implant sinking rates were 2.86% (1/35) for the 3D-printed group and 8.33% (3/36) for the Prestige LP group (Χ² = 1.001, P = 0.317), with no occurrence of prosthesis displacement. The incidence of heterotopic ossification (HO) was 2.86% (1/35) in the 3D-printed group and 19.44% (7/36) in the Prestige LP group (Χ² = 4.884, P = 0.027), and the incidence of adjacent segmental degeneration (ASD) was 2.86% (1/35) and 8.33% (3/36), respectively (Χ² = 1.001, P = 0.317).
Conclusion:Similar to Prestige LP, 3D-printed artificial discs have demonstrated significant clinical efficacy in treating single-level cervical spondylosis, with a lower incidence of HO.