The Short And Mid Term Comparison Of Cervical Disc Arthroplasty Versus Dynamic Cervical Implant For The Management Of Cervical Spondylopathy

Objection To observe the short and mid term clinical outcomes of cervical non-fusion inthe treatment of spondylotic radiculopathy or myelopathy,for providing a reference for theclinical treatment of cervical disease.Methods From January,2008to December,2011,we applied31cases of cervicalnon-fusion(34levels),eighteen of whom are males.Among these cases,there are18caseswith spondylotic myelopathy,and13cases with spondylotic radiculopathy. Preoperatively,all patients were given CT,MRI examination,AP and Lateral X-Rays as well asextension-flexion views to get the range of motion(ROM) and to exclude cases with any ofthe associated problems as follows:severe degenerative signs,acute infection,osteoporosis,and so on.Following procedure,we have all patients followed up and all cases we requiredAP,Lateral and dynamic X-rays,aiming to recheck the position of implants as well as thestability of it.And we also concern about anterior disc height,posterior disc height,discangle and the ROM of the treated levels.Clinically,we evaluated the efficiency of thetreatment according to VAS scores and JOA scores.Results All the patients got timely follow-up,the span of which averaged at29months(4-48months).Compared with those before operation,the average VAS scoresimproved4.8at neck and5.2at upper limbs after operation respectively.According to JOAscores,the mean value was9.86±1.57properatively,and15.57±5.69postoperatively(P＜0.05).All cases showed successful outcomes with18cases being excellent and9casesbeing fair.Radiologically,we found that anterior disc height of treated cervical segment was 4.8±1.1preoperatively and7.6±1.7postoperatively,and the difference was of statisticalimportance(P＜0.05);for posterior disc height,the preoperative one was2.8±0.7,and thepostoperative one was4.1±0.8,and the difference was of statistical importance(P＜0.05);for disc angle, the preoperative one was4.9±2.8,and the postoperative one was7.9±3.5,and the difference was of statistical importance(P＜0.05);for ROM of treated level, thepreoperative one was8.2±1.0,and the postoperative one was8.8±0.6,and the differencewas of statistical importance(P＜0.05).There were no occurrence of failures of prosthesissuch as subsidence,loosening,excursion,or hetero-ossification.Conclusions By using cervical non-fusion,we had achieved reliable and satisfactoryoutcomes both clinically and radiologically.However,we must be aware that cervicalnon-fusion remains to be proved as a better choice by the means of sufficient,long-termand randomized clinical trials. Objective to compare post-operatively short and mid term clinical outcomes and therestoration of disc height,disc angle,range of motion at surgical level between cervicaldisc replacement group and dynamic cervical implant group,and try to found out if there isany statistical difference between the two groups.Methods We chose20cases(21levels) treated with Total Disc Replacement,and11cases(13levels) with DCI.Among TDR group,9males,11females;cervical spondyloticmyelopathy being12cases,and cervical spondylotic radiculopathy for8cases.Among DCIgroup,9males,2females; cervical spondylotic myelopathy being9cases,and cervicalspondylotic radiculopathy for2cases.Preoperatively,we evaluated the cervical spondyloticmyelopathy cases by JOA scores,postoperatively we had all treated patients reexamined with AP,lateral and dynamic lateral (extension-flexion bending)views during follow-up at6months,12months,24months,36months respectively,aiming to observe disc height,disc angle and range of motion at surgical levels for both two groups.Results both the two groups showed good clinical outcomes by JOA scores,but we saw nostatistical significance between them(P＞0.05).Postoperatively,there was no differencebetween two groups concerning posterior disc height,disc angle and range of motion attreated levels(P＞0.05)；for anterior disc height,we saw statistical difference(P＜0.05).Conclusion Clinical outcomes of both two groups are satisfactory,all of them can preservemotion at cervical levels,also can restore disc height and disc angle,so we found that TotalDisc Replacement and dynamic cervical implant were one of better choices for thetreatment of cervical spondylopathy.