Artikel
Anterior cervical disc arthroplasty for the treatment of degenerative disorders – clinical outcome and MRI-based findings of series of 24 patients with a mean follow-up of 11 years
Zervikale Bandscheibenprothesen als Therapie der degenerativen Erkrankung der Halswirbelsäule – klinische und MRT-basierte Daten einer Serie von 24 Patienten mit einem mittleren Verlaufsuntersuchungszeitraum von 11 Jahren
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Veröffentlicht: | 26. Juni 2020 |
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Objective: The ideal surgical technique for the treatment of degenerative disorders of the cervical spine has not been determined yet. Cervical disc arthroplasty (CDA) has been evolved to reduce the development of adjacent segment degeneration which might become symptomatic (sASD) and lead to repeated procedure. Studies with long-term clinical outcome and MRI data following CDA are rare.
Methods: A retrospective file review of all patients who underwent CDA for degenerative disorder between 2005 and 2010 was performed. Inclusion criteria for further evaluation were a complete set of preoperative, postoperative and follow-up documentation of the neurological status and documentation of repeated procedures. At final follow-up with a personal examination was performed and clinical outcome was assessed via Odom’s criteria, Neck disability index (NDI). Degeneration of the cervical spine was assessed via a five step grading system (range 0 -1) based on the MRI scan.
Results: A total of 95 patients were identified and 82 among those fulfilled inclusion criteria. 1- and 2-level CDA was performed in 61 and 21 patients respectively. In nine (10.9%) patients repeated procedures was performed. In seven (8.5%) for sASD and in two (2.4%) due to failure of the CDA. The mean interval between initial CDA and repeated procedure was 52 months (range: 5-107 months). Prior to preparation of this abstract, 24 patients (10 male und 14 female) with a mean age of 58 years attended the final follow-up examination. The mean follow-up was 11 years (range 9-14 years), mean NDI score was 18%, eighteen patients (75%) reported clinical success according to Odom’s, and 22 (91%) patients reported that they would choose CDA as treatment again. The grade of degeneration at the adjacent segments to CDA was moderate, with a mean of 0.45 and 0.35, respectively.
Conclusion: The clinical success rate following CDA for the treatment of degenerative disorders reached only 75% within 11 years. The repeated procedure rate was 10.9%. The MRI based grade of degeneration of the cervical spine was moderate.