Short-term Curative Outcome Comparison Between Discover Artificial Cervical Disc Replacement And Anterior Cervical Decompression With Cage And Bone Graft Fusion

ObjectiveTo analyze and compare the short-term clinical effect between Discover artificialcervical disc replacement and anterior cervical decompression with cage and bonegraft fusion in the treatment of single segment cervical spondylosis.MethodFrom January2009to March2013，22patients with single segment cervicalspondylosis underwent cervical disc replacement (CDR) using Discover artificialcervical disc from Johnson company and28patients underwent anterior cervicaldecompression with cage and bone graft fusion (ACDF) in our hospital. Their clinicaldata retrospectively analyzed. Patients were divided into two groups: artificialcervical disc group(group A) and cage fusion group(group B). There was nosignificant difference in age, gender, follow-up time，preoperative JOA score andoperative segment between two groups. The operation time, operative blood loss,hospitalization time, pre-and postoperative Japanese Orthopaedic Association (JOA)scores, visual analogue scale (VAS) score, neck disability index (NDI) and Odomscores were evaluated to compare the clinical curative effects between these twogroups. The range of motion (ROM) from C2to C7, operative and adjacent levelswere also measured and compared between two groups.ResultThe mean follow-up time was25.50±9.36months in group A and27.68±9.54months in group B. There was no significant difference (P>0.05) in operation time,operative blood loss, hospitalization time between two groups. The JOA score weresignificantly improved and VAS score and NDI were significantly decreased (P<0.01)at the end of follow-up in both two groups compared to preoperative data. Theimprovement of NDI at the last follow-up was better in group A than in group B, which had statistically significant difference (P<0.01). However, the improvementrate of JOA score had no statistical difference between two groups (P>0.05). Theexcellent and good rate evaluated by Odom was81.82%in group A and82.14%inGroup B, which had no significant difference between two groups (P>0.05). In groupA, the postoperative range of motion (ROM) of C2-C7, operative and adjacent levelshad no statistical difference (P>0.05) compared to the preoperative ROM. In group B,the postoperative range of motion (ROM) of C2-C7, operative and adjacent levelswere much less when compared to the preoperative ROM, which had statisticaldifference (P<0.01). One patient in group A aggravated after surgery, who received asecondary cervical fusion surgery and the symptoms relieved after that. One patient ingroup A found bone resorption at three months follow-up, fortunately the boneresorption disappeared at6months and2years follow-up.Conclusions1.Both Discover artificial cervical disc replacement and anterior cervicaldecompression with cage and bone graft fusion have short-term curative effect inthe treatment of cervical spondylosis.2.Compare to ACDF, CDR can retain the mobility of the operative segment andcervical spine, and the mobility of adjacent segments did not increase, which maybe able to prevent adjacent segment degeneration.