Comparison of Motion Changes and Clinical Outcomes between Cervical Disc Replacement and Anterior Cervical Discectomy and Fusion in Single Level Cervical Degenerative Disease: Retrospective Analysis
|Sang-Deok Kim1, Jung-Kil Lee1*, Jae-Won Jang1, Hyung-Sik Moon1, Soo-Han Kim1 and Dae-Yong Kim2|
|1Department of Neurosurgery, Chonnam National University Medical School & Research Institute of Medical Sciences, Gwangju, Korea|
|2Department of Neurosurgery, Dong-Gwangju Woori Hospital, Gwangju, Korea|
|Corresponding Author :||Jung-Kil Lee
Department of Neurosurgery
Chonnam National University Hospital 671
Jebongno, Dong-gu, Gwangju, 501-757
Republic of Korea
E-mail: [email protected]
|Received March 29, 2012; Accepted April 20, 2012; Published April 23, 2012|
|Citation: Kim SD, Lee JK, Jang JW, Moon HS, Kim SH, et al. (2012) Comparison of Motion Changes and Clinical Outcomes between Cervical Disc Replacement and Anterior Cervical Discectomy and Fusion in Single Level Cervical Degenerative Disease: Retrospective Analysis. J Spine 1:116. doi:10.4172/2165-7939.1000116|
|Copyright: © 2012 Kim SD, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Objective: Cervical Total Disc Replacement (CTDR) has recently been developed as an alternative to Anterior Cervical Discectomy and Fusion (ACDF) in cervical degenerative disease to preserve the motion at the treated level. The aim of this study is to investigate the safety and efficacy of CTDR by comparing it with ACDF in the treatment of
single-level cervical degenerative disease, retrospectively.
Methods: This study included 61 patients, who underwent either stand-alone single-level ACDF (n = 33) or singlelevel CTDR (Bryan cervical artificial disc, n = 28) at C3 to C7 for degenerative cervical disease between June 2007 and December 2009. Cervical radiographs were obtained to measure overall and regional cervical angle and Range
of Motion (ROM). For evaluation for patient’s pain, visual analogue scale and Japanese Orthopedic Association score was measured.
Results: The changes of the overall Cervical Sagittal Angle (CSA) were not significantly different between the two groups. The Segmental Angle (SA) was maintained at a significantly higher in the CTDR group compared to the ACDF group during the follow-up period (p < 0.05). The ROM of the upper adjacent segment was significantly increased in the ACDF group compared to the CTDR group.
Conclusions: Clinically, CTDR is at least as efficient as ACDF. CTDR using a Bryan artificial disc provided a significant maintenance of the SA and the ROM at the treated level, and prevented the hyper-mobility at the upper adjacent segment compared to the ACDF. In the Future, prospective, randomized, long-term follow-up study with
large-number will be required to clarify the efficacy of CTDR.