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RESEARCH PRODUCT

Comparison of 2 Zero-Profile Implants in the Treatment of Single-Level Cervical Spondylotic Myelopathy: A Preliminary Clinical Study of Cervical Disc Arthroplasty versus Fusion

Shuang ZhengWen YuanXin-feng LiLili YangSheng ShiZu-de Liu

subject

MaleKinematicsPhysiologymedicine.medical_treatmentlcsh:MedicineAnterior cervical discectomy and fusionOssificationProsthesisLaryngology0302 clinical medicineMedicine and Health SciencesMedicine030212 general & internal medicineRange of Motion Articularlcsh:ScienceIntervertebral DiscProstheticsMultidisciplinaryPhysicsClassical MechanicsDysphagiaProstheses and ImplantsMiddle Agedmedicine.anatomical_structureTreatment OutcomeConnective TissueSpinal fusionPhysical SciencesCervical VertebraeFemaleBone RemodelingAnatomyRange of motionCervical vertebraeResearch ArticleBiotechnologyDiskectomyAdultmedicine.medical_specialtySurgical and Invasive Medical ProceduresSpinal Cord DiseasesArthroplasty03 medical and health sciencesMusculoskeletal System ProceduresFunctional spinal unitHumansArthroplasty ReplacementLigamentsbusiness.industrylcsh:RBiology and Life SciencesIntervertebral discArthroplastySurgeryBiological TissueSpinal FusionOtorhinolaryngologylcsh:QMedical Devices and EquipmentSpondylosisbusinessPhysiological Processes030217 neurology & neurosurgery

description

Objectives Cervical disc arthroplasty (CDA) with Discover prosthesis or anterior cervical discectomy and fusion (ACDF) with Zero-P cage has been widely used in the treatment of cervical spondylotic myelopathy (CSM). However, little is known about the comparison of the 2 zero-profile implants in the treatment of single-level CSM. The aim was to compare the clinical outcomes and radiographic parameters of CDA with Discover prosthesis and ACDF with Zero-P cage for the treatment of single-level CSM. Methods A total of 128 consecutive patients who underwent 1-level CDA with Discover prosthesis or ACDF with Zero-P cage for single-level CSM between September 2009 and December 2012 were included in this study. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score and Neck Disability Index (NDI). For radiographic assessment, the overall sagittal alignment (OSA), functional spinal unit (FSU) angle, and range of motion (ROM) at the index and adjacent levels were measured before and after surgery. Additionally, the complications were also recorded. Results Both treatments significantly improved all clinical parameters (P 0.05). Besides, no significant differences existed in dysphagia, subsidence, or adjacent disc degeneration between the 2 groups (P > 0.05). However, significant differences occurred in prosthesis migration in CDA group. Conclusions The results of this study showed that clinical outcomes and radiographic parameters were satisfactory and comparable with the 2 techniques. However, more attention to prosthesis migration of artificial cervical disc should be paid in the postoperative early-term follow-up.

yearjournalcountryeditionlanguage
2016-07-01PLoS ONE
10.1371/journal.pone.0159761http://europepmc.org/articles/PMC4956276