Disc prosthesis versus fusion with cage in single level cervical degenerative spine disease – A retrospective case-control patient reported outcome study

• Published in: Clinical neurology and neurosurgery Vol. 233; p. 107933
• Main Authors: Nielsen, Teresa Haugaard, Nanthan, Kumanan Rune, Rasmussen, Mikkel Mylius, Bjarkam, Carsten Reidies
• Format: Journal Article
• Language: English
• Published: Assen Elsevier B.V 01.10.2023; Elsevier Limited
• Subjects: Adjacent segment disease; Anterior cervical discectomy and fusion (ACDF); Arthroplasty; Biomechanics; Cervical degenerative disc disease; Cervical disc arthroplasty; Clinical outcomes; Degenerative diseases; Hospitals; Intervertebral discs; Joint surgery; Neck; Neck pain; Neurology; Pain; Pathology; Patient satisfaction; Patients; Prostheses; Spine (cervical); Statistical analysis; Denmark; Aarhus Denmark; Adjacent segment disease; Cervical degenerative disc disease; Anterior cervical discectomy and fusion (ACDF); Cervical disc arthroplasty
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2023.107933

To compare the clinical outcome of single level cervical degenerative spine disease treated surgically with motion preserving anterior cervical disc arthroplasty versus anterior cervical discectomy and fusion (ACDF). Patients treated with cervical disc arthroplasty at Aalborg University Hospital and ACDF at Aarhus University Hospital were matched 1:2. Primary outcome measures were Neck Disability Index (NDI), EQ-5D-3 L and Numeric rating scale (NRS) for arm- and neck pain. Data was collected by telephone interviews regarding present and retrospective data. 50 patients treated with cervical disc arthroplasty were matched to 100 ACDF patients covering November 2011 to December 2018. Mean improvements for NRS neck pain three-months postoperative, and NDI were significantly better in the cervical disc arthroplasty group, with intergroup differences of 1.56 (p = 0.02) and 5.01 (p = 0.01) respectively. A subgroup analysis of the half of the cohort with the longest follow-up (mean 7.6 years) showed, in favour of cervical disc arthroplasty, mean improvements of NDI: 8.80 (p = 0.00), EQ5D: − 0.19 (p = 0.04), NRS neck three months follow-up: 3.70 (p = 0.00) and long follow-up: 2.54 (p = 0.01) and NRS arm three months follow-up: 2.02 (p = 0.01). Radiologic examination indicated preserved mobility in 80% of the implanted protheses at 24-month post-surgical follow-up. Surgical treatment of one level degenerative cervical spine disease with cervical disc arthroplasty or anterior cervical discectomy and fusion has a similar good clinical outcome after a mean follow-up of 5.6 years. However, cervical disc arthroplasty displayed long-term superiority in the half of the cohort with the longest follow-up time averaging 7.6 years. •Cervical anterior decompression in general is beneficial in single level cervical disease.•Disc arthroplasty and anterior discectomy and fusion have good clinical outcomes.•Cervical disc arthroplasty displays long-term superiority.