Alexander M Satin, Tara Shenker, Richard D Guyer, Scott L Blumenthal, Jack E Zigler, Jessica L Shellock, Peter B Derman, Donna D Ohnmeiss, Mary P Rogers-LaVanne
{"title":"颈椎间盘置换术治疗颈前路椎间盘切除术融合后临近节段疾病。","authors":"Alexander M Satin, Tara Shenker, Richard D Guyer, Scott L Blumenthal, Jack E Zigler, Jessica L Shellock, Peter B Derman, Donna D Ohnmeiss, Mary P Rogers-LaVanne","doi":"10.1097/BRS.0000000000005215","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A retrospective chart review was conducted at a single institution.</p><p><strong>Objective: </strong>The purpose of this study was to investigate the clinical outcomes of cervical disc arthroplasty (CDA) used for the treatment of symptomatic adjacent segment disease (ASD) developed after anterior cervical discectomy and fusion (ACDF).</p><p><strong>Background: </strong>A major clinical concern following ACDF is the development of ASD. ASD after ACDF is often treated with an additional fusion, but risks include pseudoarthrosis and further ASD. CDA is a motion-preserving alternative that addresses these concerns, and therefore, has been proposed as an alternative treatment for ASD after ACDF.</p><p><strong>Materials and methods: </strong>Patients who underwent CDA at level(s) adjacent to a prior ACDF (n = 120) were identified from a consecutive series of patients who underwent CDA at one institution. Pre-CDA to post-CDA patient-reported outcome measures were compared using the paired Wilcoxon signed-rank test.</p><p><strong>Results: </strong>A total of 142 devices were implanted-98 patients underwent a 1-level CDA, and 22 patients underwent a 2-level CDA. The mean follow-up duration after CDA was 32.11 months. Neck pain, arm pain, and Neck Disability Index scores significantly improved from the preoperative to postoperative time point (respectively: 6.14-3.02, 4.42-1.61, 44.28-28.62, all P < 0.001). In total, 7 patients underwent reoperation (5.83%). One of these patients underwent reoperation for pseudarthrosis at the level of ACDF following a hybrid procedure. The indications for index level reoperations (n = 3) were foraminal stenosis, osteolysis, and postoperative hematoma. All patients with an adjacent level reoperation (n = 3) received surgery at levels adjacent to the prior fusion, not the more recent CDA.</p><p><strong>Conclusion: </strong>The results of this study found that CDA was effective for the treatment of ASD following ACDF. CDA appears to be a viable treatment option for ASD after ACDF in appropriately selected patients.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":"50 4","pages":"243-251"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cervical Disc Arthroplasty for the Treatment of Adjacent Segment Disease After Anterior Cervical Discectomy and Fusion.\",\"authors\":\"Alexander M Satin, Tara Shenker, Richard D Guyer, Scott L Blumenthal, Jack E Zigler, Jessica L Shellock, Peter B Derman, Donna D Ohnmeiss, Mary P Rogers-LaVanne\",\"doi\":\"10.1097/BRS.0000000000005215\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>A retrospective chart review was conducted at a single institution.</p><p><strong>Objective: </strong>The purpose of this study was to investigate the clinical outcomes of cervical disc arthroplasty (CDA) used for the treatment of symptomatic adjacent segment disease (ASD) developed after anterior cervical discectomy and fusion (ACDF).</p><p><strong>Background: </strong>A major clinical concern following ACDF is the development of ASD. ASD after ACDF is often treated with an additional fusion, but risks include pseudoarthrosis and further ASD. CDA is a motion-preserving alternative that addresses these concerns, and therefore, has been proposed as an alternative treatment for ASD after ACDF.</p><p><strong>Materials and methods: </strong>Patients who underwent CDA at level(s) adjacent to a prior ACDF (n = 120) were identified from a consecutive series of patients who underwent CDA at one institution. Pre-CDA to post-CDA patient-reported outcome measures were compared using the paired Wilcoxon signed-rank test.</p><p><strong>Results: </strong>A total of 142 devices were implanted-98 patients underwent a 1-level CDA, and 22 patients underwent a 2-level CDA. The mean follow-up duration after CDA was 32.11 months. Neck pain, arm pain, and Neck Disability Index scores significantly improved from the preoperative to postoperative time point (respectively: 6.14-3.02, 4.42-1.61, 44.28-28.62, all P < 0.001). In total, 7 patients underwent reoperation (5.83%). One of these patients underwent reoperation for pseudarthrosis at the level of ACDF following a hybrid procedure. The indications for index level reoperations (n = 3) were foraminal stenosis, osteolysis, and postoperative hematoma. All patients with an adjacent level reoperation (n = 3) received surgery at levels adjacent to the prior fusion, not the more recent CDA.</p><p><strong>Conclusion: </strong>The results of this study found that CDA was effective for the treatment of ASD following ACDF. CDA appears to be a viable treatment option for ASD after ACDF in appropriately selected patients.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\"50 4\",\"pages\":\"243-251\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-02-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005215\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005215","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/13 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Cervical Disc Arthroplasty for the Treatment of Adjacent Segment Disease After Anterior Cervical Discectomy and Fusion.
Study design: A retrospective chart review was conducted at a single institution.
Objective: The purpose of this study was to investigate the clinical outcomes of cervical disc arthroplasty (CDA) used for the treatment of symptomatic adjacent segment disease (ASD) developed after anterior cervical discectomy and fusion (ACDF).
Background: A major clinical concern following ACDF is the development of ASD. ASD after ACDF is often treated with an additional fusion, but risks include pseudoarthrosis and further ASD. CDA is a motion-preserving alternative that addresses these concerns, and therefore, has been proposed as an alternative treatment for ASD after ACDF.
Materials and methods: Patients who underwent CDA at level(s) adjacent to a prior ACDF (n = 120) were identified from a consecutive series of patients who underwent CDA at one institution. Pre-CDA to post-CDA patient-reported outcome measures were compared using the paired Wilcoxon signed-rank test.
Results: A total of 142 devices were implanted-98 patients underwent a 1-level CDA, and 22 patients underwent a 2-level CDA. The mean follow-up duration after CDA was 32.11 months. Neck pain, arm pain, and Neck Disability Index scores significantly improved from the preoperative to postoperative time point (respectively: 6.14-3.02, 4.42-1.61, 44.28-28.62, all P < 0.001). In total, 7 patients underwent reoperation (5.83%). One of these patients underwent reoperation for pseudarthrosis at the level of ACDF following a hybrid procedure. The indications for index level reoperations (n = 3) were foraminal stenosis, osteolysis, and postoperative hematoma. All patients with an adjacent level reoperation (n = 3) received surgery at levels adjacent to the prior fusion, not the more recent CDA.
Conclusion: The results of this study found that CDA was effective for the treatment of ASD following ACDF. CDA appears to be a viable treatment option for ASD after ACDF in appropriately selected patients.
期刊介绍：
Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store.
Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
