Introduction: Several studies have established the safety and efficacy of cervical disc arthroplasty (CDA) as compared to anterior discectomy and fusion (ACDF). There are few single center comparative trials, and current studies do not contain large numbers of patients. We set out to perform a single center, review in comparison of CDA to ACDF.
Methods: We performed a retrospective cohort comparison review at a single, military institution to capture all patients who underwent single-level CDA or single-level ACDF. Radiographs and patient charts were reviewed by independent researchers to determine multiple outcome variables. Data were analyzed descriptively and through the use of student t-tests where applicable.
Results: There were 198 patients included in the study. The CDA group contained 110 patients and the ACDF group had 88 patients. Average follow up time was 9.7 (±8.8) months. The CDA and ACDF groups demonstrated 90.9% and 86.4% rates of symptom relief, respectively. 93.6% of patients who underwent CDA were able to return to full activity, as compared to 88.6% in the ACDF group. The rates for recurrent laryngeal nerve (RLN) injury and dysphagia were 3.6% and 5.5%, respectively, in the CDA group. The ACDF group had no RLN injuries and 3.4% of patients reported dysphagia. The CDA group had a 16.4% rate of persistent posterior neck pain. The ACDF group had 11 patients (12.5%) with persistent posterior neck pain, and a rate of symptomatic pseudoarthrosis requiring reoperation of 2.3%.
Conclusions: : In the largest non-sponsored study of its kind to date, our data suggest that both CDA and ACDF result in approximately 90% (93.6% CDA and 88.6% ACDF) of patients with complete symptom relief and a relatively low complication rate. Patients who underwent CDA had a higher rate of persistent posterior neck pain, and patients who underwent ACDF were at risk for symptomatic pseudoarthosis.
Patient Care: Improve clinical knowledge regarding both CDR and ACDF
Learning Objectives: By the conclusion of this session, participants should be able to compare the outcomes and complications of CDA versus ACDF