Pandey Praveen Kumar, Pawar Inder, Gupta Jyoti, Verma Raaghav Rai
Department of Orthopaedics, ESI-PGIMSR Model Hospital, New Delhi, New Delhi, India.
Department of Anaesthesia, Dr. RML Hospital, New Delhi, New Delhi, India.
Spine (Phila Pa 1976). 2017 Jan 1;42(1):E41-E49. doi: 10.1097/BRS.0000000000001696.
A single-center, prospective comparative study of prospectively collected outcomes, with a minimum 12 months follow-up.
The primary purpose of the study is to investigate the clinical, functional, and radiological outcomes of cervical total disc replacement (CTDR) in comparison with anterior cervical discectomy and fusion (ACDF) in the treatment of single-level cervical disc degenerative disease, prospectively.
CTDR has recently been an alternative to ACDF in cervical disc degenerative disease to preserve the motion at the treated level.
This study included 34 patients, who underwent either single-level ACDF (n = 17) or single-level CTDR (n = 17) at C3 to C7 level for cervical disc degenerative disease between July 2012 to April 2014 with a minimum of 12 months of follow-up.
Neck disability index, visual analog scale, and neck-arm pain score showed significant difference between the two groups at final follow-up of 12 months. Modified orthopedic association score and Nurick scale also showed the Japanese significant difference between the two groups at final follow-up of 12 months. Odom criteria were not statistically significant between the two groups at final follow-up. The changes in overall cervical sagittal angle (CSA) were significantly different between the two groups. The segmental angle (SA) was maintained at a significantly higher value in the CTDR group than in the ACDF group during the follow-up period (P < 0.05). The range of motion of the cervical spine and the treated level was well maintained and improved in the CTDR group as compared with ACDF group and showed extremely statistically significant difference between the two groups.
CTDR was found to be a safe, effective, better, and efficient alternative to the traditional ACDF. CTDR using Prestige LP cervical disc provided a statistically significant clinical, functional, and radiological outcomes between the two groups after 1-year follow-up.
一项单中心前瞻性比较研究，对前瞻性收集的结果进行至少12个月的随访。
本研究的主要目的是前瞻性地比较颈椎间盘置换术（CTDR）与颈椎前路椎间盘切除融合术（ACDF）治疗单节段颈椎间盘退变疾病的临床、功能和影像学结果。
最近，CTDR已成为颈椎间盘退变疾病中ACDF的替代方法，以保留治疗节段的活动度。
本研究纳入了34例患者，他们在2012年7月至2014年4月期间因颈椎间盘退变疾病在C3至C7节段接受了单节段ACDF（n = 17）或单节段CTDR（n = 17）治疗，并进行了至少12个月的随访。
在12个月的最终随访中，两组之间的颈部残疾指数、视觉模拟量表和颈臂疼痛评分显示出显著差异。改良骨科协会评分和Nurick量表在12个月的最终随访中两组之间也显示出显著差异。在最终随访中，两组之间的Odom标准无统计学意义。两组之间颈椎矢状面总角度（CSA）的变化有显著差异。在随访期间，CTDR组的节段角度（SA）维持在显著高于ACDF组的值（P < 0.05）。与ACDF组相比，CTDR组颈椎和治疗节段的活动度得到了良好的维持和改善，两组之间显示出极其显著的统计学差异。
发现CTDR是传统ACDF安全、有效、更好且高效的替代方法。使用Prestige LP颈椎间盘的CTDR在1年随访后两组之间提供了具有统计学意义的临床、功能和影像学结果。
2级。
