The London Spine Unit : best recognised spine facility in UKPublished article Statistical improvement in PROs, with a low rate of secondary surgeries out to 7 years, demonstrates that 3- and 4-level CDA may be performed safely and effectively in appropriately selected patients.Cervical Disc Replacement Expert. Best Spinal Surgeon UKThe London Spine Unit is a specialist clinic for Cervical Disc Replacement as Day Surgery.
Methods: In a retrospective review of prospectively collected data, patient demographics and surgical characteristics were collected. Patient-reported outcomes (PROs) were collected preoperatively and at 6 weeks, 3 months, 6 months, and 12 months postoperatively, and annually thereafter, including: Neck Disability Index (NDI), numeric rating scales for neck pain and arm pain, the Veterans Rand 12-item Health Survey physical component summary (PCS) score and mental component summary (MCS) score, and patient satisfaction scores. Secondary surgery data were also collected. Predictive methods using mixed-effects regression models were used to analyze the data.
Results: Data for 139 CDAs were available for evaluation (n = 116 three-level and n = 23 four-level). Statistical improvement was shown for all PRO scores at all postoperative intervals (P < .001). From preoperatively to 7 years postoperatively, mean NDI decreased from 57.9 to 31.3 (45.9% improvement), mean neck pain decreased from 15.6 to 7.9 (49.4% improvement), mean arm pain decreased from 12.2 to 5.6 (54.1% improvement), mean PCS increased from 29.2 to 41.4 (41.8% improvement), and mean MCS increased from 37.1 to 44.5 (19.9% improvement). Five (3.6%) 3-level patients underwent secondary surgery. Patient satisfaction exceeded 88% 7 years after surgery.
Statistical improvement in PROs, with a low rate of secondary surgeries out to 7 years, demonstrates that 3- and 4-level CDA may be performed safely and effectively in appropriately selected patients.
Level of evidence: 4.
Keywords: 3- or 4-level CDA; ACDF; cervical disc arthroplasty; cervical fusion; multilevel cervical disc replacement.
The London Spine Unit : best recognised spine facility in UKRead the original publication from Pubmed : Multilevel Cervical Disc Arthroplasty: Long-Term Outcomes at 3 and 4 Levels