3D printed anatomical bionic artificial cervical disc replacement for single-level cervical spondylosis: a cohort study

Abstract

Background: Cervical disc replacement (CDR) is considered to be an effective alternative treatment to anterior cervical discectomy and fusion (ACDF). However, the use of most artificial disc prostheses can lead to complications due to the high morphological and dimensional mismatch with the human neck anatomy. Objective: By comparing the clinical efficacy of the new 3D printed artificial cervical disc with ACDF in treating cervical spondylosis, to study the clinical value of the artificial disc with the appropriate morphological and dimensional. Methods: This study was a retrospective analysis of 58 patients with single-segment cervical spondylosis who met the inclusion criteria between August 2019 and July 2022 at XXXX Hospital. The patients were divided into two groups based on the surgical method used: 38 cases in the ACDF group and 20 cases in the CDR group. The patients' general information, including operation time, intraoperative blood loss, and hospital stay, were recorded. The clinical effect was evaluated using the visual analog scale (VAS), Japanese Orthopedic Association (JOA) score, and Neck Disability Index (NDI). The radiological effect was evaluated using the range of movement (ROM) by the shell angle. Complications, including dysphagia, heterotopic ossification, and adjacent segment degeneration (ASD), were also recorded. Results: The average follow-up time for the ACDF and CDR groups was 18.18 ± 2.19 and 17.50 ± 7.18 months, respectively (P =0.682). The surgical time was 134.76 ± 39.35, 144.50 ± 35.69 (P =0.359), and the hospital stay was 6.74 ± 1.63 and 7.00 ± 2.00 days (P =0.593). In terms of clinical efficacy, the two groups showed significant clinical efficacy, and there was no difference in VAS (P =0.046), JOA (P =0.046), and NDI (P =0.046) scores at each time point. However, the blood loss of the two groups was 170.00 ± 110.50ml and 118.42 ± 80.15ml, and the CDR group was significantly higher than the ACDF group (P=0.046). In terms of imaging, the postoperative ROM in the ACDF group was lower than that in the CDR group (P=0.005). In terms of complications, a few patients in both groups experienced swallowing discomfort after surgery and recovered within 3 months. One case of ASD occurred in the ACDF group, and no ectopic ossification was observed in either group. Conclusion: The new 3D-printed artificial disc for treating single-segment cervical spondylosis has shown proven clinical efficacy, and it maintains better ROM compared to ACDF, although it may have more intraoperative blood loss.