Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation: which has greater effects on adjacent segment degeneration?

doi:10.3969/j.issn.2095-4344.2016.04.009

Abstract

Abstract:

BACKGROUND: Studies showed that both anterior cervical disc replacement and anterior cervical decompression and fusion can achieve good clinical result in cervical spondylosis. However, it is not conclusive
about which kind of surgical method has an advantage in avoiding the adjacent segment degeneration.
OBJECTIVE: To compare the effect on adjacent segment degeneration of single segment cervical disc herniation treated with anterior cervical decompression and fusion and anterior cervical disc replacement.
METHODS: We collected clinical data of 178 patients with cervical disc herniation and receiving anterior cervical disc replacement or anterior cervical decompression and fusion from January 2009 to December 2012. A retrospective analysis was performed. There were 116 cases in the anterior cervical decompression and fusion group and 62 cases in the anterior cervical disc replacement group.
RESULTS AND CONCLUSION: (1) Evaluation: visual analogue scale score, Japanese Orthopaedic Association Scores and neck disability index were improved significantly in both groups during final follow-up compared with that pre-treatment (P < 0.05). (2) No significant difference in range of motion of operation segment, adjacent upper segment and adjacent lower segment was detected between final follow-up and pre-operation in the anterior cervical disc replacement group (P > 0.05). At 3 months after surgery, in the anterior cervical decompression and fusion group, surgical segment was confluent, and range of motion lost. During final follow-up, range of motion of adjacent upper segment and adjacent lower segment was significantly increased, and the increased range of motion in the upper segment was bigger than that of the lower segment (P < 0.05). (3) During final follow-up, X-ray films and MRI images revealed the number of degenerated adjacent segment was more in the anterior cervical decompression and fusion group than in the anterior cervical disc replacement group (P < 0.05). The number of degenerated middle and upper segments was more than that of the lower segment in both groups (P < 0.05). (4) The findings confirmed that anterior cervical disc replacement or anterior cervical decompression and fusion for treating cervical disc herniation could effectively relieve nerve symptoms of patients. However, compared with the anterior cervical disc replacement, adjacent segment degeneration occurs more commonly after anterior cervical decompression and fusion.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Liu Wei, Sheng Wei-bin, Zhang Jian, Deng Qiang, Guo Hai-long. Anterior cervical disc replacement and anterior cervical decompression and fusion for treating single segment cervical disc herniation: which has greater effects on adjacent segment degeneration? [J]. Chinese Journal of Tissue Engineering Research, 2016, 20(4): 504-510.

Figures/Tables 4

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