Abstract
Introduction
The clinical outcomes of Multi-level disc arthroplasties are variable in the literature. However, the outcome results related to age would have a significant bearing on our decisions in considering patients for surgery. We reviewed 51 patients who had 3 & 4-level cervical disc arthroplasties at our center.
Methods
The study involved a retrospective review of prospectively collected data on Multi-level (three and four levels) cervical arthroplasty patients with an average age of 54.64 (median age: 52, range: 34–80). Fifty one patients were followed up for 2 to 5 years based on clinical outcomes scores which were reviewed using data including NDI (Neck Disability Index), Depression, Anxiety, Bodily Pain, Visual Analogue score for Neck (VAS Neck), and Visual Analogue score for Arm (VAS Arm). Scores were collected pre-operatively and at each follow up at 3 months, 6 months, 1st and yearly afterwards. Linear Regression Analysis was performed to look at the impact of age on these scores.
Results
The study consisted of 24 females and 27 males. The average duration of symptoms was ~62 months (range: 0–300months) for Multilevel Cervical Arthroplasty patients. The indication for surgery was radiculopathy and a combination of radiculopathy and myelopathy. Linear Regression Analysis for NDI and age showed a Pearson Co-relation (r = 0.243); P Value: 0.051, for VAS Neck (r = 0.251); P Value: 0.044, VAS Arm (r = 0.392); P Value: 0.001. The slope on the scatter plots for these 3 outcome scores showed there was a better outcome with age. There was significant improvement in the score with age (< 0.05).
Conclusion
Our results indicate that there is a strong co-relation between age of the patient and their NDI, VAS Neck and VAS Arm scores in Multi-level Cervical Disc Arthroplasty. It would appear that the advancing age results are better. The reason is most likely multifactorial including duration of pre op symptoms, severity of pathology and patient expectations.