title: Outcomes of single-level cervical disc arthroplasty versus anterior cervical discectomy and fusion.
abstract: Several studies have established the short-term safety and efficacy of cervical disc arthroplasty (CDA) as compared to anterior cervical discectomy and fusion (ACDF). However, few single-center comparative trials have been performed, and current studies do not contain large numbers of patients. We retrospectively reviewed all patients from a single military tertiary medical center between August 2008 to August 2012 who underwent single-level CDA or single-level ACDF and compared their clinical outcomes and complications. A total of 259 consecutive patients were included in the study, 171 patients in the CDA group with an average follow-up of 9.8 (±9.9)months and 88 patients in the ACDF group with an average follow-up of 11.8 (±9.6)months. Relief of pre-operative symptoms was 90.1% in the CDA group and 86.4% in the ACDF group with rates of return to full pre-operative activity of 93.0% and 88.6%, respectively. Patients who underwent CDA had a higher rate of persistent posterior neck pain (15.8% versus 12.5%), and patients who underwent ACDF were at risk for symptomatic pseudarthrosis at a rate of 3.4%. Reoperation rates were higher in the ACDF group (5.7% versus 3.5%). To our knowledge, this review is the largest, non-funded, comparison study between single-level CDA and single-level ACDF. This study demonstrates that CDA is a safe and reliable alternative to ACDF in the treatment of cervical radiculopathy and myelopathy resulting from spondylosis and acute disc herniation.
authors.affiliation: Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Tracey
authors.affiliation: Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Cody
authors.affiliation: Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA. Electronic address: scott.cameron.wagner@gmail.com.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Wagner
authors.affiliation: Department of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Rosner
authors.affiliation: Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Building 19, Bethesda, MD 20889, USA; Division of Orthopaedics, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Lehman
mesh_terms: D000328:Adult; D001178:Arthroplasty / Q000379:methods / Q000706:statistics & numerical data*; D002574:Cervical Vertebrae / Q000601:surgery*; D003680:Deglutition Disorders / Q000453:epidemiology / Q000209:etiology; D017586:Diskectomy / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006772:Hospitals, Military; D006801:Humans; D016268:Internal Fixators; D055959:Intervertebral Disc Degeneration / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D019547:Neck Pain / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D011542:Pseudarthrosis / Q000453:epidemiology / Q000209:etiology; D011843:Radiculopathy / Q000209:etiology / Q000601:surgery; D020127:Recovery of Function; D012008:Recurrence; D061226:Recurrent Laryngeal Nerve Injuries / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D062707:Return to Work; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000209:etiology; D013123:Spinal Fusion / Q000706:statistics & numerical data*; D013126:Spinal Nerve Roots / Q000293:injuries; D062606:Tertiary Care Centers; D059145:Total Disc Replacement / Q000295:instrumentation / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Cervical disc arthroplasty; Cervical disc replacement; Cervical fusion; Degenerative disc disease; Radiculopathy