Clinical Study Following Artificial Cervical Disc Replacement In The Treatment Of Cervical Spondylotic Myelopathy

Object: Reveal and analyze the clinical effects of Bryan cervical disc replacement in the treatment of patients with cervical spondylotic myelopathy. Evaluate its clinical efficacy in the long term and guide its clinical treatment.Materials and Methods: We reviewed 22 patients with cervical spondylotic myelopathy who underwent Bryan cervical disc replacement from Feb.2005 to Apr.2007. The clinical and radiographic follow-up were performed preoperatively and postoperatively to evaluate the clinical effects. Clinical efficacy were analyzed by JOA scores, NDI and VAS. Static and dynamic X-ray radiographs were made to measure ROM of cervical vertebra, the treated segment and the FSU; and the curveture of cervical vertebra and the FSU to evaluate its effects on the biomechanics of cervical vertebra. CT and MRI were also made preoperatively and postoperatively. Periods were categorized as early follow-up( <6 months) and late follow up( >6 months).Results: Neurological deficit was alleviated in all patients. All patients were followed up at least 24 months, JOA scores, NDI and VAS were all improved postoperatively and the differences had statistical significances. ROMs of cervical vertebra, the treated segment and the FSU decreased in early follow-up, but they all returned to normal level in late follow-up and the differences had no statistical significance. The curvature of cervical vertebra and the FSU all increased postoperatively and the difference had statistical significance. No replacement related complications were found. Also no adjacent disc obvious degeneration or heterotopic ossification was founded during our follow-up.Conclusions: Artificial cervical disc replacement can obviously improve the symptoms of patients of cervical spondylotic myelopathy and achieve good clinical results. Meanwhile, the replaced level retains ROMs of cervical vertebra, the treated segment and the FSU. The curvature of cervical vertebra and the FSU are reestablished. So, the artificial cervical disc replacement is an effective treatment of cervical spondylotic myelopathy. But some longer follow-up are still needed to evaluate the clinical effects.