Abstract
Introduction
Anterior cervical discectomy and fusion is still the “gold standard” for surgical treatment of patients with single-level cervical disc disease but in the past decade it has been challenged by total cervical disc replacement which offers several advantages over it.
Materials and Methods
A total of 100 patients with a single level cervical disc disease who fulfilled the inclusion and exclusion criteria were treated with total cervical disc replacement using Discover artificial cervical disc (DePuy Spine Inc., Raynham, Massachusetts) between May 2008 and September 2010. All patients were evaluated with pre- and postoperative serial radiographic studies (MRI, standard and functional cervical spine X-rays), and clinically. For clinical evaluation we used neck disability index (NDI), visual analog scale (VAS) for neck and arm pain and neurological status at 3, 6, 12, 24, and 48 months.
Results
The results of our study show that total cervical disc replacement using Discover provides excellent radiological and clinical outcomes in long-term follow-up during minimally 48 months. Patients showed significant improvement in clinical parameters, NDI and VAS (arm and neck) at follow-up visits. None of the patients developed adjacent disc disease. During the follow-up period in 15 of our patients heterotopic ossification occurred with complete loss of range of motion at the treated level (15%). Also we had one patient with the prosthesis migration at the 2-year follow-up visit who was reoperated. There were no other major surgery-related complications.
Conclusion
Discover total cervical disc replacement is according to our study safe and efficient method for surgical treatment of a single level cervical disc disease in selected patients with excellent outcome at long-term follow-up.