Results of a Large Single-center Retrospective Review of Cervical Disc Arthroplasty

Meeting Highlight from NASS 2014

Cervical spineScott Wagner, MD presented Outcomes Following Cervical Disc Arthroplasty: A Retrospective Review during the 29th Annual Meeting of the North American Spine Society in San Francisco, CA.

Study Summary
The authors indicated this is largest non-sponsored, single-center study of cervical disc arthroplasty (CDA). This retrospective review analyzes 176 consecutive patients who underwent CDA from 2008 to 2012.  The purpose of the study was to evaluate short-term outcomes and complications of these patients.

  • 40 females (22.7%); average age 42
  • Surgical indication in 141 patients was radiculopathy (84.4%)
  • Surgical indication in 13 patients was myelopathy (7.8%)
  • Surgical indication in 10 patients was radiculopathy and myelopathy (6%)

The retrospective analysis included patients undergoing any CDA:

  • Single level
  • Two-level
  • Anterior cervical discectomy and fusion (ACDF) with hybrid
  • 111 patients underwent single-level CDA (63.1%)
  • 52 patients underwent CDA/ACDF (29.5%)
  • 13 patients underwent 2-level CDA (7.4%)

“The most common levels of disease that we encountered were C5-6 and C6-7,” indicated Dr. Wagner. The variables evaluated included the surgical indication, levels treated, complications (eg, axial neck pain, laryngeal nerve injury) postoperative range of motion, and resolution of symptoms. In military patients, the return to full active duty without restrictions was evaluated.

Dr. Wagner reported, “We found there was a 93% rate of complete neurologic relief of symptoms in patients undergoing cervical disc arthroplasty, as well as a 92% rate of return to unrestricted full activity, and a 90.4% rate of active duty patients returning to unrestricted full duty.”

He also indicated, “We did find, interestingly, an 18% rate of persistent axial neck pain lasting longer than 3 months in patients undergoing any of these cervical disc constructs. And our rates of persistent dysphasia and reoperation rate are comparable to that that’s in the literature. We did find that the patients undergoing multilevel hybrid constructs did have higher rates of complications and decreased rates of symptomatic relief and return to full activity.”

The short-term results demonstrated that cervical disc arthroplasty is a safe and reliable treatment for cervical radiculopathy.

Updated on: 01/25/16
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