Results of treatment of one- or multi-level discopathy with use of artificial cervical disc

Author(s): MACIEJ TĘSIOROWSKI, EWA LIPIK, DANIEL ZARZYCKI, TOMASZ POTACZEK, BARBARA JASIEWICZ, KRZYSZTOF ŁOKAS

Introduction: Traditional method of treatment of degenerative disc disease in the cervical spine is discectomy and anterior fusion. Fusion, due to loss of motion of the affected segment may be followed by acceleration of degenerative changes in the adjacent levels. Artificial cervical disc allows preservation of motion of segment; it also decompressed neural structures and decreases pain. The goal of this work is clinical and radiologic assessment of results of one- level or multilevel cervical alloplasty in patients with cervical disc disease. Material and methods: Material consists of 34 patients (23 women and 11 men), 45 artificial discs were implanted. Two-level disc implantation was performed in eleven cases. The most frequent level of surgery was the C5/C6 disc – 29 patients, then C4/C5 – 10, C6/C7 – 4 patients and C3/C4 – 2 patients. Additionally, two patients underwent laminoplasty C3-C6 due to circular examination. Mean age at surgery was 45 years (29 – 64yrs). We analyzed the course of intervention and the clinical results: pain severity (VAS scale), neck disability index (NDI), active range of motion of the cervical spine compared with the preoperative examination. Above that early and late complications were noted. Mean follow up period was 19 months (from 12 to 40 months). Mean time of surgery of surgery was 142 min (69 - 246 min), and blood loss - 100ml, (0 - 200ml). Results: All patients revealed decreasing of pain from 8.2 (4-10) to 4.3 (1-9) in VAS scale. Improvement of NDI index was observed. Increase of range of motion was observed postoperatively, reaching the average range of motion for the age group. Radiologically segmental kyphotic deformity was noted in all cases, av. 7.6o (0o - 29o). After surgery segmental kyphosis decreased and was observed only in 19 cases, av. 4.5o, in all other cases cervical lordosis was restored. There were no serious complications in the observation group. Transient postoperative complications were noted: Horner syndrome – 2 cases, dysphagia with suspicion of prosthesis luxation – 1 case. Conclusions: Cervical alloplasty is an effective method of treatment of cervical disc disease. Operation causes restoring of mobility of the involved segment.