[Effectiveness of cervical disc replacement for cervical myelopathy].
OBJECTIVE
To evaluate the effectiveness of cervical disc replacement for cervical myelopathy.


METHODS
Between October 2006 and October 2008, 20 patients (26 segments) with cervical myelopathy underwent single-level (14 segments) or bi-level (6 segments) cervical disc replacement. There were 8 males and 12 females with an average age of 46 years (range, 26-65 years). The disease duration ranged 2-18 months (mean, 7 months). The effectiveness was evaluated using visual analogue scale (VAS) score, cervical range of motion (ROM), and the Odom et al. criteria. Heterotopic ossification (HO), osteophyte formation, and prosthesis loosening were observed.


RESULTS
All incisions healed by first intention, with no severe complication. Twenty patients were followed up 30-48 months (mean, 34 months). At 28 months after operation, according to Odom et al, criteria, the results were excellent in 17 cases and good in 3 cases. The VAS scores of the neck, shoulder, and upper limb were significantly improved when compared with preoperative scores (P < 0.05). At 30 months after operation, X-ray films showed that 20 replaced segments were mobile and ROM was (10.6 +/- 4.5) degrees, showing no significant difference (P > 0.05) when compared with that of upper adjacent segment (10.8 +/- 3.7) degrees and lower adjacent segment (7.5 +/- 4.2) degrees. HO occurred in 10 cases (13 segments). No displacement, subsidence, or loosening occurred except 1 case of retrodisplacement of the prosthesis.


CONCLUSIONS
Cervical disc replacement can obtain good effectiveness. It can maintain normal cervical ROM and physiological curvature. But it needs further long-term follow-up to evaluate the function and the influence on the adjacent segments.
Department of Spinal Surgery, Affiliated Hospital of Guilin Medical University, Guilin Guangxi 541001, PR China. ydx562828@sina.com
Dongxue
D
Yan
Zengming
Z
Xiao
Chong
C
Shen
Yongji
Y
Huang
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000601:surgery; D007595:Joint Prosthesis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013128:Spinal Osteophytosis / Q000000981:diagnostic imaging / Q000601:surgery*; D059145:Total Disc Replacement / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome