A Comparison of Anterior Cervical Discectomy and Fusion versus Fusion Combined with Artificial Disc Replacement for Treating 3-Level Cervical Spondylotic Disease.
10.3340/jkns.2016.1010.013
- Author:
Seo Ryang JANG
1
;
Sang Bok LEE
;
Kyoung Suok CHO
Author Information
1. Department of Neurosurgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University, Uijeongbu, Korea. leesb@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Cervical spondylosis;
Arthroplasty;
Anterior cervical discectomy fusion;
Total disc replacement
- MeSH:
Arm;
Arthroplasty;
Diskectomy*;
Humans;
Incidence;
Neck;
Postoperative Complications;
Range of Motion, Articular;
Spondylosis;
Total Disc Replacement*
- From:Journal of Korean Neurosurgical Society
2017;60(6):676-683
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. METHODS: Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. RESULTS: Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. CONCLUSION: The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.
