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Cervical Disc Arthroplasty With Systematic Total Bilateral Uncuscectomy – Adapted Technique Particularly In Severe Spondylosis: A Prospective Study – Cervical Disc Replacement

The article discusses the potential benefits of expanding the indications for cervical disc arthroplasty (CDA) by adapting the surgical technique for severe spondylosis. The study compared the clinical outcomes of patients treated with CDA and systematic total bilateral uncuscectomy to those treated with anterior cervical discectomy and fusion (ACDF). The results showed that patients treated with CDA and uncuscectomy had greater improvements in pain levels, neck disability, and overall function compared to those treated with ACDF. Additionally, no difference was found between patients with severe spondylosis and those without when treated with CDA and uncuscectomy. These findings suggest that this surgical technique can be effective in reducing cervical pain and improving function even in cases of severe spondylosis

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most advanced day surgery hospital in UK

Published article

INTRODUCTION: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA.

Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Introduction: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA. Research question: Is it possible to expand the indications for the implantation of cervical prostheses,

Abstract

Introduction: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA.

Research question: Is it possible to expand the indications for the implantation of cervical prostheses by adapting the surgical technique, particularly for severe spondylosis, to benefit from the advantages of prostheses over ACDF ?

Materials and methods: We propose a prospective two-center study to compare the possible clinical benefit of the placement of a cervical prosthesis with systematic total bilateral uncuscectomy (or uncinectomy) compared to the classical technique of ACDF, particularly for severe spondylosis. Visual analog scales for brachialgia, cervicalgia, and neck disability index were measured before and one year after surgery. Odom’s criteria were assessed one year after surgery.

Results: We compared 81 patients treated with CDA and systematic total bilateral uncuscectomy versus 42 patients treated with ACDF for symptomatic radicular or medullary compression. Patients treated with CDA and uncuscectomy showed greater improvements in VASb, VASc, NDI, and Odom’s criteria than those treated with ACDF, with statistically significant results. Moreover, no difference was found between the severe spondylosis subgroup and the non-severe spondylosis subgroup treated with CDA and uncuscectomy.

Discussion and This study assessed the value of systematic total bilateral uncuscectomy for cervical arthroplasty. Our prospective clinical results suggest a surgical technique to reduce cervical pain and improve function one year after surgery, even in cases of severe spondylosis.

Keywords: Cervical disc arthroplasty; Cervical prosthesis; Severe spondylosis; Uncinectomy; Uncuscectomy.

The London Spine Unit : most advanced day surgery hospital in UK

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Cervical disc arthroplasty with systematic total bilateral uncuscectomy – Adapted technique particularly in severe spondylosis: A prospective study

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Abstract Introduction: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA. Research question: Is it possible to expand the indications for the implantation of cervical prostheses

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