title: Cervical disc arthroplasty for the treatment of spondylotic myelopathy and radiculopathy.
abstract: The concept of cervical disc arthroplasty (CDA) for the anterior treatment of cervical pathology has existed for approximately half a decade. In this time, multiple devices have been developed for this purpose, with the ultimate aim to provide an alternative to fusion. Fifty-five patients with cervical spondylotic radiculopathy and myelopathy underwent CDA over a 5 year period. Data was collected on 46 patients, which included Visual Analogue Scale scores for neck pain and arm pain, Neck Disability Index scores, Short Form-36 v2 (SF-36) and Nurick grades for myelopathy patients. Preoperative data and data obtained at the latest clinical follow-up (median 48 months, range, 10-76 months) were analysed to assess the intermediate term efficacy of the procedure. In patients with radiculopathy, arm pain improved by 88% (p<0.001). In those presenting with myelopathy, the Nurick grades improved from a median of 1 to 0 (p<0.001). In both groups of patients, improvements in pain and neurologic deficit were accompanied by significant improvements in multiple domains of the SF-36. Using a composite system which considered neck pain, arm pain, function and myelopathy, we arrived at an overall success rate of 73%. We concluded that CDA is an effective intervention for improving neurologic deficit, arm pain and local neck symptoms that translated into improvements in physical and social functioning in the intermediate term.
authors.affiliation: St George Public Hospital, Gray Street, Kogarah, NSW 2217, Australia. Electronic address: petekhong@yahoo.com.
authors.forename: Peter
authors.initials: P
authors.lastname: Khong
authors.forename: Nikolai
authors.initials: N
authors.lastname: Bogduk
authors.forename: Ali
authors.initials: A
authors.lastname: Ghahreman
authors.forename: Mark
authors.initials: M
authors.lastname: Davies
mesh_terms: D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods*; D002574:Cervical Vertebrae / Q000473:pathology; D004185:Disability Evaluation; D017586:Diskectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011843:Radiculopathy / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000379:methods; D013128:Spinal Osteophytosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroplasty; Cervical; Myelopathy; Radiculopathy; Replacement