Associated factors of disc replacement for cervical spondylotic radiculopathy

English Keywords:Cervical spondylotic radiculopathy  Artificial disc replacement  Prognostic factors

English Abstract:

  【Abstract】 Objectives: To investigate the associated factors of cervical disc replacement for cervical spondylotic radiculopathy(CSR). Methods: A retrospective study of 45 patients undergoing cervical total disc replacement(CTDR) in orthopedics of Changzheng Hospital from May 2012 to May 2014 was carried out. The follow-up was 6 months to 2 years, with an average of 1.4 years. Group was considered as effective when having following conditions: (1)neck disability index(NDI) scores improved(last follow-up NDI score-preoperative NDI score)>15; (2)at final follow-up, surgery segmental nerve root was kept intact; (3)no failed surgery and revision surgery; (4)and radiologically, no limited mobility and prosthesis-related problems. Anyone who was not satisfied was in no effective group. The general data and subjective variables were compared between two groups. General data included gender, age, duration of disease, smoking history, nerve damage under EMG detection, preoperative muscle strength, number of surgical segment, cervical ROM, operation time, blood loss. Subjective variables included: visual analogue scale(VAS) and NDI scores. The prognostic factors were investigated to provide the basis for clinical practice. Results： 34 cases in effective group and 11 cases in no effective group were noted. The differences of age, disease duration, smoking history, nerve damage under EMG, preoperative VAS, NDI were statistically significant between 2 groups(P<0.05). Sex, number of surgery segment, cervical ROM, operative time, blood loss showed no significant difference for prognosis(P>0.05). Conclusions: Patient age, disease duration, smoking history, nerve damage under EMG, preoperative muscle strength, preoperative VAS score and preoperative NDI may be related to CTDR in CSR patients.