Comparative Efficacy Of Cervical Disc Arthroplasty And Anterior Cervical Discectomy And Fusion For The Treatment Of Single-level Cervical Spondylosis

Objectives: To compare the clinical effects between cervical disc arthroplasty and anteriorcervical discectomy and fusion in treating single-level cervical spondylosis.Methods: From January2008to July2010, a total of41patients were enrolled at oursiteas study investigating ACDF versus Prestige or NuNec cervical disc prosthesis.19patientsreceived the investigational device (Group A) and22patients underwent a single-levelACDF (Group B), and we have10cases implanted with Prestige cervical Prosthesis and9cases with NuNec cervical prosthesis in group A. There are no statistical significancebetween the gender, the age of patients, the type of cervical spondylosis, preoperative JOAscores, and the surgical level (P>0.05). intraoperative blood loss and operation time wererecorded and compared beteewn two groups. Japanese Orthopedics Association (JOA)score, neck disability index（NDI）and Visual analogue scale (VAS) neck／aim pain wereevaluated preoperatively and postoperatively. Pre-and postoperative X-rays were observedto measure range of motion (ROM) of C2-7, operative and adjacent levels.Results: Group A: The mean operation time was159.3min, and the averageintraoperative blood loss was95.0ml. Group B: The mean operation time was188.2min,and the average intraoperative blood loss was102.3ml. There were no significantdifferences in the operation time and intraoperative blood loss between the two groups(P>0.05). The follow-up time in group A was30-55months (mean43.5months), and thefollow-up time in group B was30-60months (mean40.3months). There was nosignificant difference in follow-up time (P>0.05). The postoperative scores of JOA, VASand NDI significantly improved compared with those of preoperative ones (P<0.05). Theexcellent and good rate evaluated by odom was84.2%in Group A, the excellent and good rate evaluated by odom was86.3%in Group B, there are no significant differencebetween two groups (P>0.05). Compared the pre-and postoperative ROM of C2-7,operative, upper and lower levels of each group respectively, the difference betweenpreoperative ROM and postoperative ROM of group B was statistically significant(P<0.05), while was no statistically significant of group A (P>0.05).Conclusions: Cervical disc replacement and anterior cervical discectomy and fusion areeffective treatments for single-level cervical spondylosis. however, comparing to ACDF,cervical disc replacement which can maintain the mobility of the segment and cervicalspine, but it don’t increase the mobility of adjacent segments...