Introduction: Cervical radiculopathy is a common problem in society that causes significant disability. Cervical disc arthroplasty (CDA) is increasingly being used as an alternative to anterior discectomy and fusion (ACDF). We set out to further evaluate the outcomes of cervical disc arthroplasty.
Methods: We performed a retrospective review of 176 consecutive patients undergoing CDA at a single, military tertiary medical center from 2008 to 2012. All construct types (1-level CDA, 2-level CDA/ACDF hybrid, and multi-level CDA) were included for review.
Results: Of the 176 patients, 40 were female (22.7%) with an average age of 41.6±8.1 years. Surgical indication was radiculopathy in 141 patients (84.4%), myelopathy in 13 patients (7.8%), and both in 10 patients (6.0%). Average follow-up was 8.5±7.6 months. 111 patients (63.1%) underwent single-level CDR. CDR/ACDF hybrid constructs were used in 52 patients (29.5%) and 13 patients (7.4%) underwent a two-level CDR. The most frequently addressed levels were C6-7 (42.0%) and C5-6 (39.6%). At most recent follow up, average CDA range of motion was 7.46 degrees (±3.6 degrees). 94.5% of patients experienced complete resolution of their pre-operative symptoms and 93.6% of patients returned to full activity. 36 patients (21.8%) experienced persistent posterior neck pain. Other complications included one superficial infection, five recurrent laryngeal nerve injuries and 18 patients reporting persistent dysphagia.
Conclusions: This is the largest non-sponsored single center study of cervical disc arthroplasty. Our data demonstrates relief of pre-operative symptoms (94.5%) and return to full activity (93.6%) with an average follow-up of 8.5 months. There was a low complication rate without device or implant related complications. Arthroplasty continues to be a safe and reliable option in treating patients with cervical radiculopathy or myelopathy
Patient Care: Better identify unique outcomes and complications specific to cervical disc arthroplasty
Learning Objectives: Cervical disc arthroplasty outcomes and complications