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RESEARCH PRODUCT

Cervical Disc Arthroplasty -Efficacy and Indications. Single Center Long-Term Cohort Study Compared to Rcts’ Results

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Purpose: This study aims to compare CTDR and ACDF functional outcomes and to determine whether our criterion to exclude patient from the CTDR cohort positively affects the results. Methods: We have conducted a single-center, prospective, observational study of two cohorts: CTDR n=88, and ACDF n=90. The choice of the method for the particular patient was not fully random – it depended on the assumed disqualification criterion for CTDR the lack of intra-operatively determined mobility. Both cohorts were clinically followed over the long-term (average: 8 years). Our results were summarized with the results of large randomized studies subjected by our team to a meta-analysis reported in full in separate paper.Results: The patient-reported clinical evaluations similarly improved in both cohorts at follow-ups. The only noteworthy difference is EQ-5Dindex at 6 months: CTDR=0.79 in compare to ACDF=0.85, correllating with the difference in mean sum of VAS neck pain intensity and frequency scores: CTDR=7,1 and ACDF=5,6. However, the difference was not significant (p>0,05). The frequency of reoperation related to ASD in our study was 1.9%/level/year in ACDF and 0.6%/level/year in CTDR. The comparison of all these results with the results of the meta-analysis did not show any statistically or clinically significant differences. Conclusion: Our study reveals that both methods are functionally effective. On the other hand, the assumed thesis that the lack of intra-operatively observed mobility of the index segment was to constitute a contraindication to CTDR cannot be considered true according to the comparison of our own study and meta-analysis results.