title: Cervical Arthroplasty for Traumatic Disc Herniation: An Age- and Sex-matched Comparison with Anterior Cervical Discectomy and Fusion.
abstract: BACKGROUND
  The efficacy and safety of using cervical arthroplasty for degenerative disc disease have been demonstrated by prospective, randomized and controlled clinical trials. However, there are scant data on using cervical arthroplasty for traumatic disc herniation. Therefore, this study aimed to investigate the outcomes of patients who underwent cervical arthroplasty for traumatic disc herniation.
  
  
  METHODS
  This cohort included patients who were admitted through the emergency department for trauma. Only patients who had newly-onset, one- or two-level cervical disc disease causing radiculopathy or myelopathy were identified. None of these patients had previously sought for medical attention for such problems. Those patients who had severe spinal cord injury (i.e. American Spinal Injury Association scale A, B or C) or severe myelopathy (i.e. Nurick scale 4 or 5), bony fracture, dislocation, perched facet, kyphotic deformity, or instability were also excluded. An age- and sex-matched one-to-one comparison was made between patients who underwent cervical arthroplasty, on the one hand, and anterior cervical discectomy and fusion (ACDF).
  
  
  RESULTS
  A total of 30 trauma patients (15 in the arthroplasty group and 15 in the ACDF group) were analyzed, with a mean follow-up of 29.6 months. The demographic data were similar. Post-operation, the arthroplasty group had significant improvement in VAS of neck and arm pain, JOA, and NDI when compared to their pre-operation status. Similarly, the ACDF group also improved significantly after the operation. There were no differences between the two groups in post-operative VAS neck and arm pain, and JOA scores. The arthroplasty group maintained a range of motion in the indexed levels and had better NDI scores at 6-months post-operation than the ACDF group.
  
  
  CONCLUSIONS
  For selected patients (i.e. no spinal cord injury, no fracture, and no instability) with traumatic cervical disc herniation, cervical arthroplasty yields similar improvement in clinical outcomes to ACDF and preserves segmental mobility.
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. hsuankanchang@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. hsuankanchang@gmail.com.
authors: Hsuan-Kan
authors: HK
authors: Chang
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. wchuang518@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. wchuang518@gmail.com.
authors: Wen-Cheng
authors: WC
authors: Huang
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. jauching@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. jauching@gmail.com.
authors: Jau-Ching
authors: JC
authors: Wu
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. thtu0001@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. thtu0001@gmail.com.
authors: Tsung-Hsi
authors: TH
authors: Tu
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. leofay1978@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. leofay1978@gmail.com.
authors: Li-Yu
authors: LY
authors: Fay
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. acidbummer@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. acidbummer@gmail.com.
authors: Peng-Yuan
authors: PY
authors: Chang
authors: School of Medicine, National Yang-Ming University, Taipei, Taiwan. clwu423@gmail.com.|Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan. clwu423@gmail.com.
authors: Ching-Lan
authors: CL
authors: Wu
authors: Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. michaelchang0903@gmail.com.
authors: Huang-Chou
authors: HC
authors: Chang
authors: School of Medicine, National Yang-Ming University, Taipei, Taiwan. yuchn.chen@gmail.com.|Department of Medical Research and Education, National Yang-Ming University Hospital, I-Lan, Taiwan. yuchn.chen@gmail.com.|Institute of Hospital and Health Care Administration, National Yang-Ming University School of Medicine, Taipei, Taiwan. yuchn.chen@gmail.com.
authors: Yu-Chun
authors: YC
authors: Chen
authors: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. henrichch@gmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. henrichch@gmail.com.|Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan. henrichch@gmail.com.
authors: Henrich
authors: H
authors: Cheng
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D017586:Diskectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000293:injuries* / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000150:complications*; D010147:Pain Measurement; D011843:Radiculopathy / Q000209:etiology; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000209:etiology; D013123:Spinal Fusion; D059145:Total Disc Replacement; D016896:Treatment Outcome