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- Title
Medium-Term Outcomes Of Activ-C Artificial Disc Replacement For Symptomatic Single Level Cervical Degenerative Diseases.
- Authors
Yuqiang Wang; Yilin Liu; Limin Wang; Weidong Wang; Yang Zhang; Min Zhang; Hao Yang
- Abstract
Introduction: Anterior cervical discectomy and fusion (ACDF) is a conventional and well-accepted surgical procedure as the "gold standard" to treat symptomatic cervical disc disease. However, there is evidence showing that ACDF may result in adjacent segment degeneration. Cervical artificial disc replacement (ADR) has become a progressively popular surgical procedure to substitute ACDF in recent years. The purposes of ADR are to accomplish the same neural decompression as that of conventional fusion surgery and to restore disc height and maintain the motion of joint. However, few clinical studies have specifically aimed to assess the incidence of adjacent segment disease (ASD) after ADR. There are different conclusions about whether replacement in cervical spine will accomplish its primary purposes to improve clinical outcomes and reduce ASDs. This article will present surgical experience and mid-term effect of Activ-C artificial disc replacement. Material and Methods: A retrospective analysis of 34 cases with symptomatic single level cervical degenerative diseases received ADR from January 2012 to December 2013. There were 21 males (mean age 43.7 ± 10.3 years) and 13 females (mean age 45.2 ± 10.1 years). JOA (Japanese Orthopaedic Association), VAS (Visual analogue scale), NDI (Neck disability index), CCI (Cervical curvature index) and ROM (Range of motion) during follow-up were observed. Then all the clinical datas were analyzed. Results: All patients were treated as surgical procedures. Patients were followed up for 38 to 54 months with an average of 40.6 months. Heterotopic ossification was found in 6 cases (the incidence was 17.6%). The bone fusion in the ADR segment occurred on one case. The postoperative scores of the JOA (14.9 ± 0.8) were significantly improved compared with preoperative scores (8.1 ± 0.7) (p < 0.05), while VAS (1.2 ± 0.6) and NDI (31.4 ± 20.3) were decreased compared with preoperative ones (VAS: 7.2 ± 0.5, p < 0.05) (NDI: 51.5 ± 28.4, p < 0.05). CCI was decreased from 14.60 ± 2.94% to 14.03 ± 2.76%). However, there was no significant differences (p > 0.05). What's more, there were no significant differences between postoperative (45.2° ± 13.5°) and preoperative (47.7° ± 13.4°) ROM (p > 0.05). Conclusion: Correct installation of the Activ-C according to surgical procedures is the guarantee for the surgical effect. There is less damage on the end plate during Activ-C ADR. It is in line with demand of cervical physiological function. Medium-term outcomes of ADR is satisfactory. However, it still needs to guard against heterotopic ossification and spontaneous fusion in this surgery.
- Publication
Global Spine Journal, 2018, Vol 8, p175S
- ISSN
2192-5682
- Publication type
Article
- DOI
10.1177/2192568218771072