title: Clinical and radiologic comparison of dynamic cervical implant arthroplasty versus anterior cervical discectomy and fusion for the treatment of cervical degenerative disc disease.
abstract: This study compared the clinical and radiological outcomes of dynamic cervical implant (DCI; Scient'x, Villers-Bretonneux, France) arthroplasty versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. This prospective cohort study enrolled patients with single-level cervical degenerative disc disease who underwent DCI arthroplasty or ACDF between September 2009 and June 2011. Patients were followed up for more than 2years. Clinical evaluation included the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Neck Disability Index (NDI), Japan Orthopedic Association (JOA) score, and visual analog scale (VAS) scores for neck and arm pain. Radiological assessments included segmental range of motion (ROM), overall ROM (C2-C7), disc height (DHI), and changes in adjacent disc spaces. The VAS, SF-36, JOA, and NDI scores improved significantly after surgery in both the DCI and ACDF groups. The VAS, JOA, and SF-36 scores were not significantly different between the DCI and ACDF groups at the final follow-up. The segmental ROM at the treated level and overall ROM increased significantly after surgery in the DCI group, but the ROM in the adjacent cephalad and caudal segments did not change significantly. The mean DHI at the treated level was significantly restored after surgery in both groups. Five patients (12.8%) in the DCI group showed new signs of adjacent segment degeneration. These results indicate that DCI is an effective, reliable, and safe procedure for the treatment of cervical degenerative disc disease. However, there is no definitive evidence that DCI arthroplasty has better intermediate-term results than ACDF.
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, 51 Fucheng Road, Beijing 100048, China.
authors.forename: Zhonghai
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Shunzhi
authors.initials: S
authors.lastname: Yu
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, 51 Fucheng Road, Beijing 100048, China.
authors.forename: Yantao
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, 51 Fucheng Road, Beijing 100048, China. Electronic address: lvshunman@vip.126.com.
authors.forename: Shuxun
authors.initials: S
authors.lastname: Hou
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA Second Military Medical University, Shanghai, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA Second Military Medical University, Shanghai, China.
authors.forename: Fengning
authors.initials: F
authors.lastname: Li
authors.affiliation: Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Tiesheng
authors.initials: T
authors.lastname: Hou
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, 51 Fucheng Road, Beijing 100048, China.
authors.forename: Hongbin
authors.initials: H
authors.lastname: Zhong
mesh_terms: D000328:Adult; D019643:Arthroplasty, Replacement / Q000379:methods* / Q000592:standards; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D017586:Diskectomy / Q000379:methods* / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013123:Spinal Fusion / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome
keywords: Adjacent segment degeneration; Anterior cervical discectomy and fusion; Cervical degenerative disc disease; Complications; Dynamic cervical implant; Surgical outcome