Six-year follow-up of three-level prestige LP cervical disc replacement: a case report

Three-level Cervical Disc Replacement (CDR) is very rare and has been little reported. Many clinical surgeons are worrying about its efficacy and safety. Considering the little knowledge of three-level CDR, we present this special case of three-level Prestige LP CDR with a six-year follow-up duration. This case reports a 44-year-old female patient presenting multilevel cervical disc herniation with persisting neurological signs. Before surgery she had severe neck pain, shoulders pain and left side arm pain especially in the C5, C6 and C7 roots distribution. The visual analogue scale (VAS) for neck was 7 and the VAS for left arm was 8. SF-36 physical and psychological score was 28 and 36, respectively. The neck disability index (NDI) was 43. The surgery was performedvia a classic right Smith-Robinson approach after induction of general anesthesia in April 16, 2009. The six-year postoperative X-rays showed the good position of the implant, a satisfying disc height and cervical lordosis. The overall results of this patient of three-level Prestige LP CDR are very good even three-level CDR remains controversial about its efficacy and safety. The selection of suitable surgical candidates and determination of valid indications for three-level CDR is essential for a good outcome. The preliminary results indicate that three-level CDR is effective and safe for the treatment of multi-level cervical spondylosis, however, larger studies with longer follow-up duration are warranted.