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Cervical Arthroplasty for Traumatic Disc Herniation: An Age- and Sex-matched Comparison with Anterior Cervical Discectomy and Fusion.

Chang HK, Huang WC, Wu JC, Tu TH, Fay LY, Chang PY, Wu CL, Chang HC, Chen YC, Cheng H - BMC Musculoskelet Disord (2015)

Bottom Line: None of these patients had previously sought for medical attention for such problems.Similarly, the ACDF group also improved significantly after the operation.There were no differences between the two groups in post-operative VAS neck and arm pain, and JOA scores.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. hsuankanchang@gmail.com.

ABSTRACT

Background: The efficacy and safety of using cervical arthroplasty for degenerative disc disease have been demonstrated by prospective, randomized and controlled clinical trials. However, there are scant data on using cervical arthroplasty for traumatic disc herniation. Therefore, this study aimed to investigate the outcomes of patients who underwent cervical arthroplasty for traumatic disc herniation.

Methods: This cohort included patients who were admitted through the emergency department for trauma. Only patients who had newly-onset, one- or two-level cervical disc disease causing radiculopathy or myelopathy were identified. None of these patients had previously sought for medical attention for such problems. Those patients who had severe spinal cord injury (i.e. American Spinal Injury Association scale A, B or C) or severe myelopathy (i.e. Nurick scale 4 or 5), bony fracture, dislocation, perched facet, kyphotic deformity, or instability were also excluded. An age- and sex-matched one-to-one comparison was made between patients who underwent cervical arthroplasty, on the one hand, and anterior cervical discectomy and fusion (ACDF).

Results: A total of 30 trauma patients (15 in the arthroplasty group and 15 in the ACDF group) were analyzed, with a mean follow-up of 29.6 months. The demographic data were similar. Post-operation, the arthroplasty group had significant improvement in VAS of neck and arm pain, JOA, and NDI when compared to their pre-operation status. Similarly, the ACDF group also improved significantly after the operation. There were no differences between the two groups in post-operative VAS neck and arm pain, and JOA scores. The arthroplasty group maintained a range of motion in the indexed levels and had better NDI scores at 6-months post-operation than the ACDF group.

Conclusions: For selected patients (i.e. no spinal cord injury, no fracture, and no instability) with traumatic cervical disc herniation, cervical arthroplasty yields similar improvement in clinical outcomes to ACDF and preserves segmental mobility.

No MeSH data available.


Related in: MedlinePlus

Comparison of mean NDI scores in the arthroplasty group (n = 15). Significant improvement after surgery was noted at each follow-up time point (i.e. post-operative 6, 12 and 24 months)
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Fig2: Comparison of mean NDI scores in the arthroplasty group (n = 15). Significant improvement after surgery was noted at each follow-up time point (i.e. post-operative 6, 12 and 24 months)

Mentions: In the arthroplasty group every parameter of the clinical outcomes, including VAS neck, VAS arm, NDI, and JOA scores, demonstrated significant improvement after the operation when compared to pre-operation (Figs. 1, 2 and 3). The improvement in these clinical outcomes were similar between the arthroplasty group and the ACDF group at 6-, 12- and 24-months post-operation (Figs. 4, 5 and 6), except that the arthroplasty group had significantly better NDI scores than the ACDF group at 6 months post-operation (p = 0.049) (Fig. 5).Fig. 1


Cervical Arthroplasty for Traumatic Disc Herniation: An Age- and Sex-matched Comparison with Anterior Cervical Discectomy and Fusion.

Chang HK, Huang WC, Wu JC, Tu TH, Fay LY, Chang PY, Wu CL, Chang HC, Chen YC, Cheng H - BMC Musculoskelet Disord (2015)

Comparison of mean NDI scores in the arthroplasty group (n = 15). Significant improvement after surgery was noted at each follow-up time point (i.e. post-operative 6, 12 and 24 months)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4551526&req=5

Fig2: Comparison of mean NDI scores in the arthroplasty group (n = 15). Significant improvement after surgery was noted at each follow-up time point (i.e. post-operative 6, 12 and 24 months)
Mentions: In the arthroplasty group every parameter of the clinical outcomes, including VAS neck, VAS arm, NDI, and JOA scores, demonstrated significant improvement after the operation when compared to pre-operation (Figs. 1, 2 and 3). The improvement in these clinical outcomes were similar between the arthroplasty group and the ACDF group at 6-, 12- and 24-months post-operation (Figs. 4, 5 and 6), except that the arthroplasty group had significantly better NDI scores than the ACDF group at 6 months post-operation (p = 0.049) (Fig. 5).Fig. 1

Bottom Line: None of these patients had previously sought for medical attention for such problems.Similarly, the ACDF group also improved significantly after the operation.There were no differences between the two groups in post-operative VAS neck and arm pain, and JOA scores.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Room 508, 17F, No. 201, Shih-Pai Road, Sec. 2, Beitou, Taipei, 11217, Taiwan. hsuankanchang@gmail.com.

ABSTRACT

Background: The efficacy and safety of using cervical arthroplasty for degenerative disc disease have been demonstrated by prospective, randomized and controlled clinical trials. However, there are scant data on using cervical arthroplasty for traumatic disc herniation. Therefore, this study aimed to investigate the outcomes of patients who underwent cervical arthroplasty for traumatic disc herniation.

Methods: This cohort included patients who were admitted through the emergency department for trauma. Only patients who had newly-onset, one- or two-level cervical disc disease causing radiculopathy or myelopathy were identified. None of these patients had previously sought for medical attention for such problems. Those patients who had severe spinal cord injury (i.e. American Spinal Injury Association scale A, B or C) or severe myelopathy (i.e. Nurick scale 4 or 5), bony fracture, dislocation, perched facet, kyphotic deformity, or instability were also excluded. An age- and sex-matched one-to-one comparison was made between patients who underwent cervical arthroplasty, on the one hand, and anterior cervical discectomy and fusion (ACDF).

Results: A total of 30 trauma patients (15 in the arthroplasty group and 15 in the ACDF group) were analyzed, with a mean follow-up of 29.6 months. The demographic data were similar. Post-operation, the arthroplasty group had significant improvement in VAS of neck and arm pain, JOA, and NDI when compared to their pre-operation status. Similarly, the ACDF group also improved significantly after the operation. There were no differences between the two groups in post-operative VAS neck and arm pain, and JOA scores. The arthroplasty group maintained a range of motion in the indexed levels and had better NDI scores at 6-months post-operation than the ACDF group.

Conclusions: For selected patients (i.e. no spinal cord injury, no fracture, and no instability) with traumatic cervical disc herniation, cervical arthroplasty yields similar improvement in clinical outcomes to ACDF and preserves segmental mobility.

No MeSH data available.


Related in: MedlinePlus