Arthroplasty versus fusion for single-level cervical disc disease.

OBJECTIVE

To evaluate the effectiveness and safety of cervical arthroplasty and anterior cervical discectomy fusion methods.

METHODS

The randomised clinical trial was conducted at the neurosurgical clinic of University of Harran, Turkey, between February 2009 and January 2010. The patients had single level disc disorder between C4-C7 levels. Before surgery, all of the patients had taken medical treatment with no improvement. Surgery was conducted with anterior approach, and disc prosthesis or polyetheretherketone cage for fusion were applied after patients were randomly divided into two groups. For preoperative and postoperative clinical evaluations Neck Disability Index and Visual Analogue Scale were used. Surgical results were evaluated according to Odom's criterion, and 'excellent' and 'good' results were accepted as successful. P<0.05 was taken as statistically significant.

RESULTS

Of the 42 patients in the study, 23(54.76%) were treated with Anterior Cervical Discectomy and Fusion, and 19(45.23%) with Cervical Disc Arthroplasty. There were no statistical differences between postoperative mean Visual Analogue Scale score (p<0.86) and Neck Disability Index scores (p<0.11) in the two groups. Average decrease in lordosis angle was 1.2 degree in Arthroplasty group, while it was 1 degree in the Fusion group. Postoperative adjacent segment degeneration was not detected in either group.

CONCLUSION

Anterior Cervical Discectomy and Fusion, and Cervical Disc Arthroplasty are safe and successful methods for the treatment of single level cervical disc disease. Although the latter is a relatively new technique performed with increased frequency, but its superiority is still uncertain.