Outcomes of single-level cervical disc arthroplasty versus anterior cervical discectomy and fusion |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA;2. Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD, USA;3. Division of Orthopaedics, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA;1. Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111, USA;2. Department of Orthopedic Surgery, Brigham and Women''s Hospital, 75 Francis St, Boston, MA 02115, USA;3. Department of Orthopedic Surgery, The Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA;1. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA;2. Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY, USA;1. Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA;2. Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, 1800 Orleans Street, Zayed Building Room Rm 6220, Baltimore, MD, USA 21287;3. Department of Anesthesiology, Northwestern School of Medicine, 675 N. St, Clair Galter 17-200, Chicago, IL 60611, USA;4. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 550 N. Broadway, Ste 301, Baltimore, MD 21029, USA;5. Department of Anesthesiology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889, USA;1. Department of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, 528 Zhangheng Rd, Shanghai 201203, China;2. Department of Orthopaedic Surgery, No. 98 Hospital of PLA, 9 Chezhan Rd, Huzhou 313000, China;3. Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, 405 College Station Rd, Athens, GA 30602, USA;4. Department of Orthopaedic Surgery, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Rd, Shanghai 200003, China |
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| Abstract: | Several studies have established the short-term safety and efficacy of cervical disc arthroplasty (CDA) as compared to anterior cervical discectomy and fusion (ACDF). However, few single-center comparative trials have been performed, and current studies do not contain large numbers of patients. We retrospectively reviewed all patients from a single military tertiary medical center between August 2008 to August 2012 who underwent single-level CDA or single-level ACDF and compared their clinical outcomes and complications. A total of 259 consecutive patients were included in the study, 171 patients in the CDA group with an average follow-up of 9.8 (±9.9) months and 88 patients in the ACDF group with an average follow-up of 11.8 (±9.6) months. Relief of pre-operative symptoms was 90.1% in the CDA group and 86.4% in the ACDF group with rates of return to full pre-operative activity of 93.0% and 88.6%, respectively. Patients who underwent CDA had a higher rate of persistent posterior neck pain (15.8% versus 12.5%), and patients who underwent ACDF were at risk for symptomatic pseudarthrosis at a rate of 3.4%. Reoperation rates were higher in the ACDF group (5.7% versus 3.5%). To our knowledge, this review is the largest, non-funded, comparison study between single-level CDA and single-level ACDF. This study demonstrates that CDA is a safe and reliable alternative to ACDF in the treatment of cervical radiculopathy and myelopathy resulting from spondylosis and acute disc herniation. |
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| Keywords: | Cervical disc arthroplasty Cervical fusion Cervical disc replacement Degenerative disc disease Radiculopathy |
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