Comparison of the more than 5-year clinical outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion

Shao, Minmin; Chen, Chun‐Hui; Lin, Zhong-Ke; Wang, Xiangyang; Huang, Qi-Shan; Chi, Yong-Long; Wu, Ai-Min

doi:10.1097/md.0000000000005733

Cited by 6 publications

(3 citation statements)

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“…Traditional surgical treatment of CSR includes ACDF [5][6][7]and posterior cervical intervertebral incision, the "keyhole" surgery [8,9]. ACDF was initiated by Robinson et al in the 1950s [5], which is widely used in the treatment of cervical spondylosis, and gradually become a standard for treatment of cervical disc disease [6,7,10]. While ACDF showed a certain degree of prosthesis sedimentation, dislocation and false joint formation and other complications [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

A Long-Term Control Study of the Treatment of Cervical Radiculopathy by Percutaneous Endoscopic Posterior Cervical Discectomy and Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation

Huang

Wang

Meng³

et al. 2020

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BackgroundCervical spondylotic radiculopathy (CSR) is very common all over the world. However, there are only a few reports about the efficacy of percutaneous endoscopic posterior cervical discectomy (PEPCD) in the treatment of CSR. Anterior cervical decompression and fusion (ACDF) and PEPCD which is a better way to treat CSR need further study.MethodsFrom January 2015 to December 2016. A retrospective study of 70 patients undergoing surgery for CSR (33 using PEPCD and 37 using ACDF). The intra-operative parameters, neck disability index (NDI), neck and arm visual analog scale (VAS) score were used to assessed clinical outcome. Radiological outcomes were assessed by measuring cervical 2-7 (C2-7) lordosis, disc height index (DHI), and degree of degenerative changes at the corresponding level.ResultsThe mean follow-up period was 48.5 month (36 –66 months). Two groups can significantly improve the clinical symptoms. There was no significant difference between the two groups in clinical results (VAS, NDI). Compared with preoperative, the lordosis of C2-7 increased significantly at the last follow-up. At the last follow-up, C2-7 lordosis in the ACDF group was significantly higher than that in the PEPCD group. In PEPCD, compared with preoperative, there was no significant difference in the DHI, but the degree of disc degeneration was significantly increased at the last follow-up.ConclusionFor patients with CSR, PEPCD had similar clinical early and intermediate outcomes when compared with ACDF, with the advantages of minimally invasive. PEPCD is a sufficient and safe supplement and alternative to conventional surgery.

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Section: Introductionmentioning

confidence: 99%

A Long-Term Control Study of the Treatment of Cervical Radiculopathy by Percutaneous Endoscopic Posterior Cervical Discectomy and Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation

Huang

Wang

Meng³

et al. 2020

Preprint

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“…Как известно, ПШДФ приводит к выключению движений в оперированном позвоночно-двигательном сегменте, что является причиной развития биомеханического стресса соседних сегментов и, как следствие, развития дегенеративного заболевания смежных позвоночно-двигательных сегментов [5,6]. Все это послужило причиной разработки и внедрения в широкую клиническую практику методики тотальной артропластики (ТА) межпозвонковых дисков, позволяющей сохранить нормальную биомеханику шейного отдела позвоночника и предотвратить развитие дегенерации смежных сегментов [7].…”

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Total Arthroplasty and Anterior Cervical Discectomy With Fixation: Long-Term Results of a Randomized Clinical Trial

et al. 2019

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Objective.To perform comparative analysis of the long-term results of using the methods of total cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) in the surgical treatment of patients with single-level degenerative diseases of cervical intervertebral discs.Material and Methods.The study included 186 patients aged 21–60 years. Independent sequential randomization (1:1) of 173 patients was performed using software. The following parameters were used to evaluate patients: the VAS score of pain syndrome severity in the cervical spine and upper extremities, the Neck Disability Index (NDI) score of the quality of life, the amplitude of movements of the operated segment, the frequency of adjacent discs degeneration and of repeated surgical interventions and adverse events.Results.In the long-term follow-up, the best clinical outcomes according to VAS and NDI data were recorded in patients from the CDA group. Their amplitude of movements in the segment remained in the physiological volume. In the ACDF group, a complete fusion was verified in 83 (93.3 %) cases. A significantly higher degree of degenerative disease of superjacent intervertebral discs was revealed in ACDF group (p < 0.01), while no significant degenerative changes were recorded in the subjacent discs (p > 0.05). The number of intraoperative and early postoperative complications did not have a statistically significant intergroup difference (p > 0.05). Symptomatic degeneration of adjacent segments was verified in 2 (2.4 %) respondents from the CDA group and in 8 (9.0 %) from the ACDF group (p < 0.001). Symptomatic adverse effects were found in 3 (3.6 %) CDA patients in the form of heterotopic ossification and in 6 (6.7 %) ACDF patients in the form of pseudoarthrosis.Conclusions.The operations of total disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) are safe and effective methods of surgical treatment of patients with single-level degenerative diseases of cervical intervertebral discs. In CDA patients, significantly better clinical results were noted, as compared with the ACDF group. The CDA method allowed preserving the normal biomechanics of the cervical spine and preventing the development of degenerative disease of adjacent segments.

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“…In the article “Comparison of the more than 5-year clinical outcomes of cervical disc arthroplasty versus anterior cervical discectomy and fusion: A protocol for a systematic review and meta-analysis of prospective randomized controlled trials”, [ 1 ] which appeared in Volume 95, Issue 51 of Medicine , affiliations were listed incorrectly. Chun-Hui Chen, Zhong-Ke Lin, Xiang-Yang Wang, Qi-Shan Huang, Yong-Long Chi, and Ai-Min Wu are solely affiliated with the Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical University, Second Medical College of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.…”

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confidence: 99%