Cervical Disc ArthroplastyThe London Spine Unit : the highest rated sugical centre in LondonPublished article Both groups achieved satisfactory and comparable clinical outcomes after CDA. Despite the remarkable improvements compared with preoperative values, the cervical alignment of RK group was still significantly inferior to that of lordosis group. More HO formation occurred in RK group. Based on these results, we did not recommend CDA to the patients with preoperative RK.Cervical Disc Arthroplasty Expert. Best Spinal Surgeon UKThe London Spine Unit is a specialist clinic for Cervical Disc Arthoplasty as Day Surgery.
Abstract
Patients and methods: From 2014 to 2018, 36 patients with preoperative RK were matched with 229 patients with preoperative lordosis. The Japanese Orthopedic Association score, Neck Disability Index, Visual Analog Scale were used to evaluate clinical outcomes. Radiological evaluations included range of motion (ROM), C2-7 Cobb angle, shell angle (SA) at surgical level, functional spinal unit (FSU) angle and heterotopic ossification (HO).
Results: The mean follow-up was 40.1 months. Both groups achieved significant improvements in clinical outcomes without significant intergroup differences. Before surgery, lordosis group had significantly greater C2-7 angle (9.5° vs -8.4°), SA (1.6° vs -3.7°), and FSU (2.9° vs -3.7°). After surgery, RK group experienced significant improvements in C2-7 angle and SA compared with preoperative data. In lordosis group, C2-7 angle, SA, and FSU were maintained. At the last follow-up, the intergroup difference of C2-7 angle, SA, and FSU remained significant. ROMs were preserved in both groups. The ROM of RK group was slightly lower than that of lordosis group but failing to reach a significance. Eleven patients in lordosis group and 21 patients in RK group developed HO (P = 0.127). There was a significant greater incidence of high-grade HO (grade Ⅲ, Ⅳ) in RK group (33.3 % vs 11.1 %, P = 0.034).
Both groups achieved satisfactory and comparable clinical outcomes after CDA. Despite the remarkable improvements compared with preoperative values, the cervical alignment of RK group was still significantly inferior to that of lordosis group. More HO formation occurred in RK group. Based on these results, we did not recommend CDA to the patients with preoperative RK.
Keywords: Cervical alignment; Cervical disc arthroplasty; Heterotopic ossification; Reversible kyphosis.
The London Spine Unit : the highest rated sugical centre in LondonRead the original publication from Pubmed : Clinical and radiological outcomes of single-level cervical disc arthroplasty in the patients with preoperative reversible kyphosis: A matched cohort study