Cervical Arthroplasty for Moderate to Severe Disc Degeneration: Clinical and Radiological Assessments after a Minimum Follow-Up of 18 Months: Pfirrmann Grade and Cervical Arthroplasty.
10.3349/ymj.2014.55.4.1072
- Author:
Chang Hyun OH
1
;
Do Yeon KIM
;
Gyu Yeul JI
;
Yeo Ju KIM
;
Seung Hwan YOON
;
Dongkeun HYUN
;
Eun Young KIM
;
Hyeonseon PARK
;
Hyeong Chun PARK
Author Information
1. Department of Neurosurgery, Guro Teun Teun Hospital, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Total disc replacement;
cervical arthroplasty;
disc degeneration;
clinical outcome;
range of motion
- MeSH:
Adult;
Arthroplasty/*methods;
Cervical Vertebrae/pathology/surgery;
Female;
Follow-Up Studies;
Humans;
Intervertebral Disc/surgery;
Intervertebral Disc Degeneration/*surgery;
Male;
Middle Aged;
Range of Motion, Articular/physiology;
Retrospective Studies;
Spinal Diseases/surgery;
Treatment Outcome;
Young Adult
- From:Yonsei Medical Journal
2014;55(4):1072-1079
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Clinical outcomes and radiologic results after cervical arthroplasty have been reported in many articles, yet relatively few studies after cervical arthroplasty have been conducted in severe degenerative cervical disc disease. MATERIALS AND METHODS: Sixty patients who underwent cervical arthroplasty (Mobi-C(R)) between April 2006 and November 2011 with a minimum follow-up of 18 months were enrolled in this study. Patients were divided into two groups according to Pfirrmann classification on preoperative cervical MR images: group A (Pfirrmann disc grade III, n=38) and group B (Pfirrmann disc grades IV or V, n=22). Visual analogue scale (VAS) scores of neck and arm pain, modified Oswestry Disability Index (mODI) score, and radiological results including cervical range of motion (ROM) were assessed before and after surgery. RESULTS: VAS and mean mODI scores decreased after surgery from 5.1 and 57.6 to 2.7 and 31.5 in group A and from 6.1 and 59.9 to 3.7 and 38.4 in group B, respectively. In both groups, VAS and mODI scores significantly improved postoperatively (p<0.001), although no significant intergroup differences were found. Also, cervical dynamic ROM was preserved or gradually improved up to 18 months after cervical arthroplasty in both groups. Global, segmental and adjacent ROM was similar for both groups during follow-up. No cases of device subsidence or extrusion were recorded. CONCLUSION: Clinical and radiological results following cervical arthroplasty in patients with severe degenerative cervical disc disease were no different from those in patients with mild degenerative cervical disc disease after 18 months of follow-up.
