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Influence Of Preoperative Symptom Duration On Effectiveness Of Cervical Disc Arthroplasty In Cervical Spondylotic Radiculopathy Patients – Cervical Disc Replacement

e hospital stay compared to the early intervention group (P<0.05). At last follow-up, both groups showed significant improvements in JOA score, NDI, and VAS score compared to preoperative values (P<0.05). However, the early intervention group had greater improvements in JOA score and NDI compared to the late intervention group (P<0.05). There was no significant difference in VAS score improvement between the two groups (P>0.05).In terms of radiographic outcomes, both groups showed significant improvements in CL, C2-C7 ROM, DA, DROM, and DIH postoperatively and at last follow-up compared to preoperative values (P<0.05). There was no significant difference in these parameters between the two groups at any time point (P>0.05).The incidence of prosthesis-related complications was similar between the two groups, with no significant difference in the rates of HO, ABL, or prosthesis subsidence at last follow-up (P>0.05). Early intervention with CDA in CSR patients with symptom duration less than 24 months leads to better clinical outcomes in terms of JOA score and NDI improvement compared to late intervention. However, both early and late intervention showed similar improvements in pain relief, radiographic outcomes, and incidence of prosthesis-related complications. Further studies with larger sample sizes and longer follow-up durations are needed to confirm these findings.

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced treatment facility on Harley Street UK

Published article

Preoperative symptom duration significantly affects the effectiveness of CDA in CSR patients. Patients with preoperative symptom duration ≥24 months have longer postoperative hospital stays and potentially poorer ability to maintain CL compared with patients with preoperative symptom duration <24 months. Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract in English, Chinese Objective: To investigate the influence of preoperative symptom duration on effectiveness of cervical disc arthroplasty (CDA) in cervical spondylotic radiculopathy (CSR) patients. Methods: The clinical data of 90 CSR patients who underwent single-segment CDA between January 2008 and March 2020 and met the selection criteria were retrospectively analyzed. Based on preoperative,

Abstract

Objective: To investigate the influence of preoperative symptom duration on effectiveness of cervical disc arthroplasty (CDA) in cervical spondylotic radiculopathy (CSR) patients.

Methods: The clinical data of 90 CSR patients who underwent single-segment CDA between January 2008 and March 2020 and met the selection criteria were retrospectively analyzed. Based on preoperative symptom duration, patients were divided into an early intervention group (preoperative symptom duration <24 months) and a late intervention group (preoperative symptom duration ≥24 months). There was no significant difference in baseline data between the two groups ( P>0.05), including age, gender, body mass index, smoking status, surgical segment, preoperative neck disability index (NDI), visual analogue scale (VAS) score, cervical lordosis (CL), C 2-C 7 range of motion (ROM), disc angle (DA), disc ROM (DROM), and disc intervertebral height (DIH). The early intervention group had a slightly higher preoperative Japan Orthopedic Association (JOA) score than the late intervention group ( P<0.05). Perioperative indicators such as operation time, intraoperative blood loss, and postoperative hospital stay were recorded. The changes of JOA score, NDI, and VAS score at last follow-up compared with those before operation were used to evaluate the clinical efficacy, and the imaging evaluation of CL, C 2-C 7 ROM, DA, DROM, and DIH was performed before operation, immediately after operation, and at last follow-up. The incidence of prosthesis-related complications, including heterotopic ossification (HO), anterior bone loss (ABL), and prosthesis subsidence, was also assessed at last follow-up.

Results: Patients in both groups were followed up 24-120 months, with an average of 53.4 months. There was no significant difference in operation time, intraoperative blood loss, or follow-up duration between the groups ( P>0.05). However, the late intervention group had significantly longer postoperative hospital stay compared to the early intervention group ( P<0.05). At last follow-up, there was no significant difference in the changes of JOA score, NDI, and VAS score between the two groups before and after operation ( P>0.05). During the follow-up, there was no surgical revision in the two groups, and there was no significant difference in the incidence of HO, ABL, and prosthesis subsidence between the two groups at last follow-up ( P>0.05). Imaging evaluation showed that there was no significant difference in CL, C 2-C 7 ROM, DA, DROM, and DIH between the two groups at each time point before and after operation ( P>0.05). The intra-group comparison showed that the early intervention group could maintain the immediate postoperative CL at last follow-up, while the late intervention group had recovered to the preoperative level. Additionally, the C 2-C 7 ROM, DROM, and DA had all recovered to preoperative levels at last follow-up in both groups; meanwhile, the DIH significantly increased immediately after operation and sustained until the last follow-up.

Preoperative symptom duration significantly affects the effectiveness of CDA in CSR patients. Patients with preoperative symptom duration ≥24 months have longer postoperative hospital stays and potentially poorer ability to maintain CL compared with patients with preoperative symptom duration <24 months.

Purpose: To explore the impact of preoperative symptom duration on the efficacy of cervical disc arthroplasty (CDA) in patients with cervical spondylotic radiculopathy (CSR). .

method: The clinical data of 90 CSR patients who underwent single-level CDA from January 2008 to March 2020 and met the selection criteria were retrospectively analyzed and divided into early intervention groups according to the duration of preoperative symptoms (59 cases, preoperative symptom duration < 24 months) and late intervention group (31 cases, preoperative symptom duration ≥ 24 months). The age, gender, body mass index, smoking status, surgical level and preoperative neck disability index (NDI), pain visual analogue scale (VAS), cervical lordosis (CL), C 2~C 7There were no differences in baseline data such as range of motion (ROM), replacement segment angle (disc angle, DA), replacement segment ROM (disc ROM, DROM), replacement segment intervertebral height (DIH), etc. No statistical significance ( P>0.05); the Japanese Orthopedic Association (JOA) score of the preoperative early intervention group was slightly higher than that of the late intervention group ( P<0.05)。记录并比较两组手术时间、术中出血量、术后住院时间等围术期指标;采用末次随访时JOA评分、NDI及VAS评分较术前的变化值评价临床疗效,采用术前、术后即刻及末次随访时的CL、C 2~C 7 ROM, DA, DROM, and DIH were evaluated by imaging; at the final follow-up, the occurrence of prosthesis-related complications, including heterotopic ossification (HO) and anterior bone loss (ABL), was evaluated. and prosthesis sinking. .

result: Both groups of patients were followed up for 24 to 120 months, with an average of 53.4 months. There were no statistically significant differences in the operation time, intraoperative blood loss, and follow-up time between the two groups ( P>0.05); the postoperative hospitalization time in the late intervention group was longer than that in the early intervention group ( P<0.05)。末次随访时,两组患者JOA评分、NDI及VAS评分的手术前后变化值比较差异均无统计学意义( P>0.05). No surgical revision occurred in either group during the follow-up period, and there was no statistically significant difference in the occurrence of HO, ABL and prosthesis subsidence between the two groups at the last follow-up ( P>0.05). Imaging evaluation showed that the CL and C levels between the two groups at each time point before and after surgery were 2~C 7 There were no statistically significant differences in ROM, DA, DROM, and DIH ( P>0.05). Intra-group comparison showed that the early intervention group could maintain the immediate postoperative CL at the last follow-up, while the late intervention group’s CL had returned to the preoperative level; patients in both groups C 2~C 7 ROM, DROM and DA all returned to preoperative levels at the last follow-up, and DIH increased significantly immediately after surgery and remained until the last follow-up. .

in The duration of preoperative symptoms has a significant impact on the postoperative efficacy of CDA in patients with CSR. Compared with patients with preoperative symptom duration <24 months, those with ≥24 months have longer postoperative hospitalization and may have worse ability to maintain CL. . .

Keywords: Preoperative symptom duration; cervical disc arthroplasty; cervical lordosis; cervical spondylotic radiculopathy.

The London Spine Unit : most experienced treatment facility on Harley Street UK

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Influence of preoperative symptom duration on effectiveness of cervical disc arthroplasty in cervical spondylotic radiculopathy patients

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Abstract in English, Chinese Objective: To investigate the influence of preoperative symptom duration on effectiveness of cervical disc arthroplasty (CDA) in cervical spondylotic radiculopathy (CSR) patients. Methods: The clinical data of 90 CSR patients who underwent single-segment CDA between January 2008 and March 2020 and met the selection criteria were retrospectively analyzed. Based on preoperative

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