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Yonsei medical journal · Jan 2022
Radiological Changes in Adjacent and Index Levels after Cervical Disc Arthroplasty.
- Jun Jae Shin, Kwang-Ryeol Kim, Dong Wuk Son, Dong Ah Shin, Seong Yi, Keung-Nyun Kim, Do-Heum Yoon, and Yoon Ha.
- Department of Neurosurgery, Yongin Severance Hospital, Yonsei University School of Medicine, Yongin, Korea.
- Yonsei Med. J. 2022 Jan 1; 63 (1): 72-81.
PurposeThe purpose of this retrospective study was to evaluate radiological and clinical outcomes in patients undergoing cervical disc arthroplasty (CDA) for cervical degenerative disc disease. The results may assist in surgical decision-making and enable more effective and safer implementation of cervical arthroplasty.Materials And MethodsA total of 125 patients who were treated with CDA between 2006 and 2019 were assessed. Radiological measurements and clinical outcomes included the visual analogue scale (VAS), the Neck Disability Index (NDI), and the Japanese Orthopaedic Association (JOA) myelopathy score assessment preoperatively and at ≥2 years of follow-up.ResultsThe mean follow-up period was 38 months (range, 25-114 months). Radiographic data demonstrated mobility at both the index and adjacent levels, with no signs of hypermobility at an adjacent level. There was a non-significant loss of cervical global motion and range of motion (ROM) of the functional spinal unit at the operated level, as well as the upper and lower adjacent disc levels, compared to preoperative status. The cervical global and segmental angle significantly increased. Postoperative neck VAS, NDI, and JOA scores showed meaningful improvements after one- and two-level CDA. We experienced a 29.60% incidence of heterotrophic ossification and a 3.20% reoperation rate due to cervical instability, implant subsidence, or osteolysis.ConclusionCDA is an effective surgical technique for optimizing clinical outcomes and radiological results. In particular, the preservation of cervical ROM with an artificial prosthesis at adjacent and index levels and improvement in cervical global alignment could reduce revision rates due to adjacent segment degeneration.© Copyright: Yonsei University College of Medicine 2022.
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