COMPARISON OF THE RESULTS OF SINGLE LEVEL CERVICAL DISC ARTHROPLASTY VERSUS ANTERIOR CERVICAL DISCECTOMY IN SHORT TO MID-TERM FOLLOW-UP

OpenAlex İngilizce

Objective: The aim of this retrospective study is to compare results of single-level cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in two different centers with short to mid-term follow-up.Materials and Methods: Both surgical techniques were applied by 2 different surgeons and in 2 different centers.While ACDF was performed by the surgeon in one clinic, CDA was performed by another surgeon in another clinic, in order to avoid surgical bias, and another surgeon from a different clinic performed a statistical evaluation.Modified Japanese Orthopedic Association score (mJOA), Modic changes (MC), neck disability index (NDI) and visual analogue scale (VAS), perioperative dysphagia, and the time to return work scores of the patients were evaluated in the study.Results: Seventy-one patients were included in the study.Thirty-two of them underwent ACDF with a median follow-up period of 15 months, and 39 underwent CDA with a median follow-up period of 16 months.The median preoperative lost workdays were statistically significantly higher in the ACDF group compared to the CDA group (p=0.009).Patients in the CDA group had statistically significantly more pain intensity (p<0.001) and lower mJOA score before the surgery (p<0.001).Neck disability was significantly more severe in the ACDF group compared to the CDA group according to the preoperative NDI score (p=0.014).Improvements in VAS and mJOA scores were significantly better in the CDA group compared to the ACDF group (p=0.004 and p<0.001, respectively).The type 1 and type 2 MC were more frequent in the ACDF group than the CDA group, preoperatively.There was a statistically significant difference in preoperative MC among the groups (p=0.010).Conclusion: In our study, both surgical techniques achieved satisfactory results.However, due to the short-term nature of the study, MC could not be evaluated and a definite opinion on this matter could not be reached.