title: Dynamic Cervical Implant versus Anterior Cervical Diskectomy and Fusion: A Prospective Study of Clinical and Radiologic Outcome.
abstract: Objective To evaluate clinical and radiologic outcome in patients treated with a dynamic cervical implant (DCI) or anterior cervical diskectomy and fusion (ACDF). Study Design A prospective comparative cohort study. Methods The study included 60 patients with one- or two-level cervical degenerative disk disease (DDD) undergoing treatment with either DCI (n = 30) or ACDF (n = 30). Clinical and radiologic outcomes were assessed 3 and 12 months after surgery. Clinical scoring systems included the Visual Analog Scale for Neck (VAS-N) and Arm pain (VAS-A), the Neck Pain and Disability Scale (NPAD), and the European Quality of Life Scale (EQ-5D). Results Both the DCI and ACDF group showed significant clinical improvement 12 months after surgery using the VAS-N (p = 0.034 and p < 0.001, respectively), VAS-A (p < 0.001 and p < 0.001, respectively), NPAD (p < 0.001 and p < 0.001, respectively), and EQ-5D (p < 0.001 and p < 0.001, respectively). There were no significant differences in clinical outcome comparing both groups at the 3- and 12-month follow-up. The fusion rate at 12 months after surgery was 39.4% and 80.0% in the DCI and ACDF groups, respectively. Radiolucency was found in 90.9% in the DCI group at 12-month follow-up. Conclusion The clinical results for DCI treatment are equivalent to those for ACDF in the treatment of one- and two-level cervical DDD at 12 months after surgery. Further studies are necessary to investigate the high rates of radiolucency and fusion associated with DCI treatment.
authors.affiliation: Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Heiko
authors.initials: H
authors.lastname: Richter
authors.affiliation: Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Seule
authors.affiliation: Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hildebrandt
authors.affiliation: Department of Neurosurgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Fournier
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D004185:Disability Evaluation; D017586:Diskectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D013123:Spinal Fusion / Q000379:methods*; D059145:Total Disc Replacement / Q000379:methods*; D016896:Treatment Outcome