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Cervical disc arthroplasty seen as safe, effective for treatment of myelopathy
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ORLANDO, Fla. — At the North American Spine Society Annual Meeting, a presenter said long-term outcomes demonstrated cervical disc arthroplasty was safe and efficacious for patients with myelopathy.
“Myelopathy patients gained similar improvement from arthroplasty [as] patients with radiculopathy, so both groups were the same,” Matthew F. Gornet, MD, said during his presentation. “Myelopathy patients report similar levels of improvements from arthroplasty compared with [anterior cervical discectomy and fusion] ACDF, with fewer serious adverse events.”
Gornet and colleagues performed a retrospective analysis of prospectively collected 84-month outcomes data that compared cervical disc arthroplasty (CDA) and ACDF in 397 patients diagnosed with myelopathy, radiculopathy or both conditions. First, CDA outcomes were compared between patients with myelopathy and those with radiculopathy. Then, CDA and ACDF outcomes were compared between patients with myelopathy alone to those with myelopathy with radiculopathy.
Safety and efficacy were determined with the neck disability index (NDI), neck and arm pain scores, SF-36 physical component score (PCS), neurological status, adverse events and secondary surgery at the index and adjacent levels.
Significant improvements were seen in all patients for NDI scores, neck and arm pain scores, and SF-36 PCS. The first comparison demonstrated patients with myelopathy and patients with radiculopathy saw improvements in NDI scores, neck and arm pain scores, and SF-36 PCS. Similar proportions of patients in each group maintained or improved their neurological status. Patients with myelopathy and patients with radiculopathy had similar rates of serious adverse events and secondary surgeries at index and adjacent levels.
The second comparison showed patients who underwent CDA and those who underwent ACDF had similar NDI scores and neck and arm pain scores and SF-36 PCS. Both treatment groups had similar proportions of patients who maintained or improved their neurological status. Both groups had similar rates of secondary surgery at index and adjacent levels. Patients who underwent CDA had lower rates of serious adverse events vs. patients who underwent ACDF. – by Monica Jaramillo
Reference:
Gornet MF, et al. Paper #3. Presented at: North American Spine Society Annual Meeting; Oct. 25-28, 2017; Orlando, Fla.
Disclosure: Gornet reports no relevant financial disclosures.