Outcome of Cervical Disc Arthroplasty in Degenerative Disc Disorder

Abstract

AbstractBackground: Cervical Disc Arthroplasty (CDA) has beenconsidered as an alternative to cervical arthrodesis in thetreatment of Cervical Degenerative Disc Diseases (CDDD).Aim of Study: The aim of this study was to assess thelong-term clinical and radiographic outcomes of CDA.Patients and Methods: A total of 17 patients who under-went single-or two-level CDA with Prestige-LP Disc wereretrospectively investigated at a minimum of 4-year follow-up. Clinical assessments included Visual Analogue Scale (VAS) for neck and arm pain, Neck Disability Index (NDI),and Japanese Orthopedic Association (JOA) score. Radiologicalevaluations included Range of Motion (ROM) of the indexand adjacent levels, segmental angle, cervical sagittal align-ment, Heterotopic Ossification (HO) and Adjacent SegmentDegeneration (ASD).Results: Significant and maintained improvement in VASfor neck and arm, NDI and JOA were observed after a meanfollow-up of 54.7 months (p < 0.001). The preoperative ROMof the index level was 9.7o, which was maintained at 1-and2-year follow-up (9.3o, and 9.2o), but was decreased to 8.0oat final follow-up. Mobility was maintained in 84.2% (16/19)of the implanted prostheses at final follow-up. ROM of thesuperior and inferior adjacent segments, cervical sagittalalignment and cervical angel were all maintained. The inci-dence of HO was 36.8% at final follow-up, but it did notinfluence the clinical outcome. Radiographic ASD weredetected in 26.3% of the patients. However, the incidence ofsymptomatic ASD was only 5.2%.Conclusion: Cervical disc arthroplasty demonstrated amaintained and satisfactory clinical outcome at a minimal of4-year follow-up, with majority of the prostheses remainedmobile. Cervical disc arthroplasty can be considered as aneffective surgical method in treating CDDD.