The Application Of Cervical Spine Arthroplasty And Medium And Long Term Clinical Follow-up Results

Objective:To study the medium and long-term clinical and radiological outcome of cervical disc replacement.Methods:35 patients(12 Bryan discs,19 Prodisc-c discs and 12 PCM discs)underwent artifical cervical disc replacement from October 2004 September to August 2011.The follow-up time was 6 to 13 years,and the average time was 8.2 years.Among the cases,there were 31 cases of cervical spondylotic myelopathy and 4 cases of cervical spondylotic radiculopathy.The JOA and ONDI score and the range of ROM of the replaced segment and upper and lower segment of all patients were measured at the time of preoperation and postoperation.Results:There was no prothesis excursion or subsidence.The averaged JOA and ONDI score were no statistically significant(p?0.01)between the time of one month after operation,two years follow-up and last time follow-up.The range of ROM of the replaced segment in flextion and extension position and in right and left bending position were no statistically significant(p?0.01)between the time of preoperation,one month after operation,two years follow-up and last time follow-up.The range of ROM of the upper and lower segment in flextion and extension position and in left and right bending position were no statistically significant(p?0.01)between the time of preoperation,one month after operation,2 years after operation and last time follow-up.Conclusion: The artifical cervical disc replacement is a safe option for patients providing excellent clinical outcomes and maintenance of segmental motion on medium and long-term follow-up.Objective:To retrospectively compare the effects of cervical disc replacement(CDR)with those of anterior cervical discectomy and fusion(ACDF')in treatment of cervical spondylotic myelopathy.Methods:55 single segment cervical spondylotic myelopathy patients underwent artifical cervical disc replacement((arthroplasty group)and anterior cervical discectomy and fusion(fusion group)from October 2004 September to August 2011.The follow-up time was 6 to 13 years,and the average time was 9.1 years.The operative time,intraoperative blood loss,length of stay and complications were measured.The JOA score,ONDI score and the range of ROM of the replaced segment and adjacent segment of all patients were evaluated preoperatively and postoperatively.Results:The improvement in the ONDI and JOA scores were equivalent at each follow-up point between the two groups(P<0.01),and there was no statistical significance between the two groups(P>0.01).The range of ROM of the adjacent segment of arthroplasty group and fusion group in flextion and extension position were no statistically significant between the time of preoperation,one month after operation,2years after operation and last time follow-up(P>0.01).Conclusion:The artifical cervical disc replacement and anterior cervical discectomy and fusion are both safe options for cervical spondylotic myelopathy patients providing excellent clinical outcomes.And the artifical cervical disc replacement helps maintain the motion of adjacent segment better.