Healio
Healio
October 16, 2008
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Patients undergoing cervical disc arthroplasty return to full-time work twice as fast those who had anterior cervical fusion

TORONTO — Patients in a multicenter, prospective, randomized investigational device exemption trial for the Kineflex-C total disc arthroplasty implant demonstrated similar clinical findings at 13 months’ mean follow-up whether they underwent either cervical arthroplasty or anterior cervical disc fusion.

However, the 27 study patients in the total disc arthroplasty (TDA) group showed better overall function based on return to work and narcotics usage results, compared to the 24 patients in the fusion group. This was likely related to how well the procedure preserved spine motion, Pierce D. Nunley, MD, of the Spine Institute of Louisiana in Shreveport, told Orthopedics Today.

Nunley presented the findings here at the North American Spine Society 23rd Annual Meeting.

Beyond analyzing typical outcomes like the Visual Analog Scale (VAS) scores and Neck Disability Index (NDI), investigators decided they needed a better grasp on how cervical total disc arthroplasty (TDA) impacts back function, he said. They accomplished that by studying the two groups’ “mini-metrics,” consisting of the number of days for patients to return to work and narcotics usage data at various follow-up points, according to Nunley.

Investigators studied 51 patients (31 women, 20 men) aged 18 to 60 years old with one-level cervical disc symptoms at C3-C7, radiculopathy signs, disc disease on radiographs and NDI scores >40. Both groups were similar in their other demographics, according to the abstract.

The median time for the TDA group who received a Kineflex-C (SpinalMotion Inc.) device to return to full-time employment, including manual labor and lighter duty jobs, was 2.5 weeks vs. 6 weeks for the fusion group. Also, by the 6-week follow-up, more than half the patients in the TDA group were narcotic-free compared to 29% of fusion patients.

Preoperative mean VAS scores of 76 improved to 20 in the fusion group and 15 in the TDA group; mean NDI scores of 60 improved to 21 in the fusion group and 17 in the TDA group.

Nunley indicated he has no financial conflicts to disclose related to companies or products mentioned in this article.

Reference:

  • Nunley PD, Gordon CR, Jawahar A, et al. Total disc arthroplasty affords quicker recovery in one-level degenerative disc disease of cervical spine: Preliminary results of a prospective, randomized trial. SIPP #33. Presented at the North American Spine Society 23rd Annual Meeting. Oct. 15-18, 2008. Toronto.