Cervical Disc Arthroplasty
The London Spine Unit : most advanced spinal hospital in London
Published article
ACDF and CDA are viable options for two-level degenerative disc disease in carefully selected patients. Both approaches produced equivalent postoperative alignment changes in a 2-level operation.
Cervical Disc Arthroplasty Expert. Best Spinal Surgeon UK
The London Spine Unit is a specialist clinic for Cervical Disc Arthoplasty as Day Surgery.
Abstract
Objective: This study assesses cervical alignments after two-level cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) with anterior plate fixation.
Method: Eighty-two patients that underwent two-level CDA or ACDF in 2014-2019 were identified. Cervical alignment parameters were compared between the two cohorts. Subgroup analyses were performed to determine factors that differentiate alignment outcomes between the two procedures.
Result: While both cohorts achieved significant focal lordosis (FL) and overall cervical lordotic (CL) gains, CDA cohorts achieved significantly greater 12-month FL gain (p=0.022). However, in a multivariate analysis controlling for preoperative variables, FL gain was no longer significant. Although the CDA cSVA significantly improved at 3 (p=0.030) and 12 (p=0.007) months, these improvements were not superior to the ACDF cSVA. Male CDA patients achieved greater 12-month CL gain. CDA patients with BMI>25 achieved greater 12-month FL gain. CDA patients with symptom duration>12 months achieved greater FL gain at 3 and 12 months. CDA patients with high baseline T1 slope or cSVA achieved greater 12-month cSVA reduction. Clinical outcomes were comparable between the two cohorts. Unlike the ACDF group, CL gain in the CDA group was significantly correlated with the cSVA reduction, which was associated with significant improvement in the NDI, arm pain, and SF-12 MCS scores. Heterotopic ossification was not found to significantly affect patient outcome and cervical alignment in both cohorts.
ACDF and CDA are viable options for two-level degenerative disc disease in carefully selected patients. Both approaches produced equivalent postoperative alignment changes in a 2-level operation.
Keywords: anterior cervical discectomy and fusion; cervical alignment; cervical degenerative disc disease; cervical disc arthroplasty; two-level.
The London Spine Unit : most advanced spinal hospital in London
Read the original publication from Pubmed :