| Objection To observe the short and intermediate-term clinical outcomes of PCM cervical prosthesis in the treatment of spondylotic radiculopathy or myelopathy, plus the stability of prosthesis during follow-up and range of motion(ROM) of treated level as well as the whole cervical spineMethods From January , 2008 to December , 2008 , we applied 13 disc replacement in 12cases(13levels),three of whom are females . Among these cases, there are 10 cases with spondylotic myelopathy , and 2 cases with spondylotic radiculopathy; and we have 10 cases implanted with PCM cervical prosthesis and 2 cases with Prestige cervical prosthesis. Preoperatively, all patients were given MRI, CT examination , AP and Lateral views as well as extension-flexion and lateral bending views to get the range of motion(ROM) and to exclude cases with any of the associated problems as follows: severe degenerative signs ,acute infection ,osteoporosis, and so on . Following procedure , we have all cases followed up at the time intervals of 1.5months, 3 months, 6 months, 12 months respectively and all the patients were required AP,Lateral and dynamic X-rays , aiming to recheck the position of implants as well as the stability of it. And we are also concerned about the ROM of the treated levels,adjacent ones. Clinically, we evaluated the efficiency of this kind of the treatment according to JOA scores and Odom's scales .Results All the cases got timely follow-up , the span of which averaged at 6.5 months(3～12 months). According to JOA scales ,the mean value was 8.35±1.10 preoperatively ,and 15.88±0.73 postoperatively( P<0.05). For Odom's scales, all patients showed successful outcomes with 9 cases being excellent and 2 case being fair. Radiologically, we found that the range of motion for extension-flexion of treated cervical segment was 8.09±0.63 preoperatively and 8.95±0.64 post-operatively, and the difference was of statistical importance(P<0.05); for left-sided flexion,the preoperative one was 6.11±0.53 ,and the post-operative one was6.25±0.54, no statistical significance was found(P>0.05); for the right-sided flexion, 6.10±0.52 preoperatively, and 6.13±0.51 post-operatively ,and also no statistical importance was found(P>0.05). There were no occurrence of failures of prosthesis such as subsidence, loosening, or excursion. Also hetero-ossification was absent.Conclusions for this research , we had achieved satisfactory outcomes both clinically and radiologically, using artificial cervical disc replacement. However, we must be aware that being a new alterative to ACDF, cervical disc replacement. remains to be proved as a better choice by the means of sufficient , long-term and randomized clinical trials, especially when it comes to its clinical efficiency and raliological results in the long run.Objective to compare post-operatively short and intermediate-term clinical outcomes and the changes of range of motion(ROM) at adjacent levels between cervical disc replacement group and anterior decompression and fusion(ACDF)group and try to find out if there is any statistical difference between them.Methods in this retrospective research, we chose 12 cases (13 levels) treated with P cervical disc replacement , and 15 ones with ACDF . Among the replacement group, there was 10 cases with PCM prosthesis and 2 cases with Prestige prosthesis;8 males ,4 females. Cervical spondylotic myelopathy being 10 cases ,and Cervical spondylotic radiculopathy for 2 cases . Preoperatively, We evaluated the Cervical spondylotic myelopathy cases by JOA scaling, post-operative efficency by Odom grading and We had all treated patients reexamined with AP,Lateral and dynamic lateral (extension-flexion bending) views during follow-up at 1.5months,3months,6months,12months respectively, aiming to observe the changes of range of motion(ROM) at levels adjacent to treated levels for both two groups.Results both the two groups showed good clinical outcomes by JOA scaling and Odom grading,but we saw no statistical significance between them(P>0.05).pre-operatively, there was no difference between the two groups concerning range of motion at levels adjacent to treated ones (P>0.05); however, the post-operative ones in ACDF group did show a marked increase (P<0.05).But in the replacement group, we saw no statistical difference(P>0.05).Conclusion based on our datum ,we can conclude with some certainty that cervical disc replacement can preserve the range of motion(ROM) at operated levels as well as prevent the compensatory hyper-motion at adjacent levels, as a result , it can greatly decrease the rate of developing degenerative lesions in the long run. But those patients treated with ACDF may have the risk of developing degenerative disease for its not being able to preserve motion at treated levels. So in this respect, cervical disc development did have some advantages over ACDF.
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