Clinical study on the Discover cervical artificial disc replacement for cervical spondylosis

English Keywords:Cervical spondylosis  Cervical artificial disc replacement  Cervical anterior discectomy and fusion  Cervical spine motion

English Abstract:

  【Abstract】 Objectives: To compare the clinical outcome of the Discover cervical artificial disc replacement and anterior cervical discectomy and fusion(ACDF). Methods: From April 2009 to May 2010, a total of 101 cases of cervical spondylosis was retrospectively reviewed. All the patients were divided into Discover group and fusion group. 46 cases in Discover group(27 males, 19 females, mean age of 46.2±10.3 years) underwent Discover cervical artificial disc replacement, while 55 cases in fusion group(32 males, 23 females, mean age of 44.8±11.4 years) underwent ACDF. The visual analogue scale(VAS), neck disability index(NDI), excellent and good improvement rate and the Cobb angle of C2-C7, the functional spinal unit(FSU) angle of operative segment, the mobility of adjacent level between two groups were statistically analyzed and compared to evaluate the functional improvement of cervical spine and clinical effects of surgeries. Results: The operation time and intraoperative blood loss in fusion group was 149.3±51.7min and 213.5±42.6ml respectively. The corresponding values in the Discover group were 132.5±44.1min and 173.2±56.4ml respectively. No significant differences were found between two groups(P>0.05). The follow-up period for Discover and fusion group was 24.2±3.2 and 25.6±2.9 months respectively. No loosening, displacement or breakage of the implant was found in the two groups during the follow-up. The postoperative VAS and NDI scores improved significantly(P＜0.05) in both groups and no significant difference was found between two groups(P>0.05). The excellent and good improvement rate for Discover and fusion group was 91.3% and 87.3% respectively, which showed no statistical difference between two groups(P>0.05). No significant difference was found between the preoperative and postoperative C2-C7 Cobb angle, FSU angle and range of motion at adjacent segments in Discover group(P>0.05), but significant differences were found in fusion group (P<0.05). There were statistical differences with respect to all these parameters between 2 groups(P<0.05). Conclusions: The Discover cervical artificial disc replacement can achieve the similar clinical effect to the ACDF for cervical spondylosis, the former can preserve the cervical movement of surgical segments and have no influence on the mobility of the adjacent segments, which is an effective option for cervical spondylosis.