Brecount Hogan, Goodwin Alyssa, Hiltzik David M, Hsu Wellington K
Simpson Querrey Institute (SQI), Northwestern University, 1838 W Chicago Ave, Chicago, IL, 60622, USA.
Department of Orthopaedic Surgery, Northwestern University, 1838 W Chicago Ave, Chicago, IL, 60622, USA.
Curr Rev Musculoskelet Med. 2023 Sep;16(9):432-437. doi: 10.1007/s12178-023-09858-8. Epub 2023 Jul 12.
Cervical disc arthroplasty (CDA) for the treatment of symptomatic cervical disc herniations (CDH) is a promising treatment for professional athletes. In recent years, a number of high-profile athletes have returned to professional play within three months after CDA, raising important questions about the potential of this procedure within this patient group. We provide the first comprehensive review of available literature for the safety and efficacy of CDA in professional contact sport athletes.
CDA provides theoretical biomechanical advantages over anterior cervical discectomy and fusion (ACDF) and posterior foraminotomy (PF), as CDA is the only operation for treatment of CDH that provides neural decompression, stability and height restoration, with preserved range of motion. While the comparative long-term results from each procedure are unknown, CDA has provided encouraging promise in its use in professional contact athletes. We aim to aid ongoing discussions regarding the controversies in spine surgery for professional athletes by providing a scientific review of the available evidence-based literature involving cervical disc arthroplasty in this population. In general, we believe that CDA is a viable alternative to ACDF and PF for the contact professional athlete who requires full neck range of motion and desires an expedited return to play. For collision athletes, the short- and long-term safety and efficacy profile of this procedure is promising but still unclear.
颈椎间盘置换术(CDA)用于治疗有症状的颈椎间盘突出症(CDH),对职业运动员来说是一种有前景的治疗方法。近年来,一些知名运动员在接受CDA术后三个月内就重返职业赛场,这引发了关于该手术在这一患者群体中的潜力的重要问题。我们首次全面综述了关于CDA在职业接触性运动运动员中的安全性和有效性的现有文献。
与颈椎前路椎间盘切除融合术(ACDF)和后路椎间孔切开术(PF)相比,CDA具有理论上的生物力学优势,因为CDA是治疗CDH的唯一一种能提供神经减压、稳定性和恢复椎间隙高度且保留活动范围的手术。虽然每种手术的长期对比结果尚不清楚,但CDA在职业接触性运动员中的应用已展现出令人鼓舞的前景。我们旨在通过对该人群中涉及颈椎间盘置换术的现有循证文献进行科学综述,来帮助推动关于职业运动员脊柱手术争议的持续讨论。总体而言,我们认为对于需要颈部全范围活动且希望尽快重返赛场的职业接触性运动员,CDA是ACDF和PF的可行替代方案。对于碰撞类运动的运动员,该手术的短期和长期安全性及有效性虽前景可期,但仍不明确。