Outcomes of single-level cervical disc arthroplasty versus anterior cervical discectomy and fusion

Tracey, Robert W.; Kang, Daniel G.; Cody, John P.; Wagner, Scott C.; Rosner, Michael; Lehman, Ronald A.

doi:10.1016/j.jocn.2014.05.007

Cited by 33 publications

(16 citation statements)

References 21 publications

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“…1,3,5,6,10,24 In the past decade, a growing interest in CDR as an alternative to ACDF in multiple long-term studies has revealed outcomes that are similar to or slightly better than those for ACDF. [11][12][13][14]16,17,19,20,23,25,31 However, there are limited data regarding 30-day readmission and reoperation rates among those who have undergone 1 of these 2 procedures; the main objective of this investigation was to obtain such data. In this study, we found that patients who underwent ACDF were more likely to be readmitted within 30 days than were patients who underwent CDR.…”

Section: Discussionmentioning

confidence: 99%

Thirty-day readmission and reoperation rates after single-level anterior cervical discectomy and fusion versus those after cervical disc replacement

Bhashyam

Ramos

Nakhla

et al. 2017

FOC

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OBJECTIVE The goal of this study was to compare 30-day readmission and reoperation rates after single-level anterior cervical discectomy and fusion (ACDF) versus those after cervical disc replacement (CDR). METHODS The authors used the 2013–2014 American College of Surgeons National Surgical Quality Improvement Program database. Included were adult patients who underwent first-time single-level ACDF or CDR for cervical spondylosis or disc herniation. Primary outcome measures were readmission and/or reoperation within 30 days of the original surgery. Logistic regression analysis was used to assess the independent effect of the procedure (ACDF or CDR) on outcome, and results are presented as odds ratios with 95% confidence intervals. RESULTS A total of 6077 patients met the inclusion criteria; 5590 (92.0%) patients underwent single-level ACDF, and 487 (8.0%) patients underwent CDR. The readmission rates were 2.6% for ACDF and 0.4% for CDR (p = 0.003). When stratified according to age groups, only patients between the ages of 41 and 60 years who underwent ACDF had a significantly higher readmission rate than those who underwent CDR (2.5% vs 0.7%, respectively; p = 0.028). After controlling for patient age, sex, body mass index, smoking status, history of chronic obstructive pulmonary disease (COPD), diabetes, hypertension, steroid use, and American Society of Anesthesiologists (ASA) class, patients who underwent CDR were significantly less likely to undergo readmission within 30 days than patients who underwent ACDF (OR 0.23 [95% CI 0.06–0.95]; p = 0.041). Patients with a history of COPD (OR 1.97 [95% CI 1.08–3.57]; p = 0.026) or hypertension (OR 1.62 [95% CI 1.10–2.38]; p = 0.013) and those at ASA Class IV (OR 14.6 [95% CI 1.69–125.75]; p = 0.015) were significantly more likely to require readmission within 30 days. The reoperation rates were 1.2% for ACDF and 0.4% for CDR (p = 0.086), and multivariate analysis revealed that CDR was not associated with lower odds of reoperation (OR 0.60 [95% CI 0.14–2.55]; p = 0.492). However, increasing age was associated with a higher risk (OR 1.02 [95% CI 1.00–1.05]; p = 0.031) of reoperation; a 2% increase in risk per year of age was found. CONCLUSIONS Patients who underwent single-level ACDF had a higher readmission rate than those who underwent single-level CDR in this study. When stratified according to age, this effect was seen only in the 41- to 60-year age group. No significant difference in the 30-day single-level ACDF and single-level CDR reoperation rates was found. Although patients in the ACDF group were older and sicker, other unmeasured covariates might have accounted for the increased rate of readmission in this group, and further investigation is encouraged.

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Section: Discussionmentioning

confidence: 99%

Thirty-day readmission and reoperation rates after single-level anterior cervical discectomy and fusion versus those after cervical disc replacement

Bhashyam

Ramos

Nakhla

et al. 2017

FOC

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“…In this study, 93% of the CDA group and 86% of the ACDF group were able to return to full activity postoperatively. Also, 91% of the CDA group and 88% of the ACDF group experienced full relief of preoperative symptoms [22].…”

Section: Postoperative Activity Levelsmentioning

confidence: 91%

Cervical disc replacement surgery: biomechanical properties, postoperative motion, and postoperative activity levels

Pisano

Helgeson

2017

Curr Rev Musculoskelet Med

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Purpose of review Cervical disc arthroplasty (CDA) is an evolving technique used in the treatment of cervical disc disease. To remain up to date on studies regarding its efficacy, we sought to answer three questions: What do biomechanical studies demonstrate in regard to the kinematics of CDA? How does CDA affect cervical motion? What are the postoperative activity levels of patients after cervical disc arthroplasty? Recent findings 1) In regard to biomechanics, recent data suggests that CDA maintains motion while possibly altering facet biomechanics. 2) Radiographic data indicates a reliable maintenance of motion in the short and medium term. 3) Postoperative activity levels are assessed with clinical outcome data which demonstrate reliable improvement in pain and function.Summary The data reviewed here establishes CDA as an efficacious treatment in the relief of symptoms from CDD. It is important to note however that an evaluation of CDA would benefit from more robust data, specifically in regards to longterm clinical outcomes.

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“…Neck pain, which is commonly associated with post-operative kyphosis, was negligible as demonstrated by the VAS neck pain scores (17) . In a retrospective study by Tracey et al, single level cervical disc arthroplasty was compared with single level anterior discectomy and fusion (21) . In this cohort of 259 patients, the arthroplasty group (n=171) had a 15.8% (n=27 patients) rate of persistent neck pain, whereas the fusion group had a 12.5% (n=11 patients) rate of pain.…”

Section: Discussionmentioning

confidence: 99%

Changes in Sagittal Alignment After Cervical Disc Arthroplasty: Results of 24 Month Pilot Study

Yücesoy

Yüksel

Yüksel³

et al. 2018

sscd

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Outcomes of single-level cervical disc arthroplasty versus anterior cervical discectomy and fusion

Cited by 33 publications

References 21 publications

Thirty-day readmission and reoperation rates after single-level anterior cervical discectomy and fusion versus those after cervical disc replacement

Thirty-day readmission and reoperation rates after single-level anterior cervical discectomy and fusion versus those after cervical disc replacement

Cervical disc replacement surgery: biomechanical properties, postoperative motion, and postoperative activity levels

Changes in Sagittal Alignment After Cervical Disc Arthroplasty: Results of 24 Month Pilot Study

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