Clinical and Radiographic Results of Artificial Disc Replacement Combined with Anterior Cervical Discectomy and Fusion Versus Two-Level Anterior Cervical Discectomy and Fusion in Two-Level Cervical Disc Disease

현윤석; 신재혁; 박준식; 이진영; kimgablae; 송경원

Study Design: Retrospective case-control study. Objectives: To compare the clinical and radiographic outcomes of a hybrid construct (HC) of cervical artificial disc replacement (CADR) combined with anterior cervical discectomy and fusion (ACDF) (group I) with 2-level ACDF (group II) in patients with 2-level cervical disc disease. Summary of Literature Review: ACDF is reported to potentially promote degenerative changes in the adjacent segment. CADR has been expected to reduce the risk of adjacent segment degeneration. However, its clinical course has yet to be sufficiently clarified. Materials and Methods: Twenty-six patients underwent 2-level cervical disc surgery. Single-level CADR combined with ACDF was performed in 14 patients. Twelve patients underwent 2-level ACDF. Clinical profiles were assessed using the neck disability index (NDI) and visual analogue scale scores of arm and neck pain. Dynamic lateral cervical radiographs were obtained preoperatively and at 1, 6, 12, and 18 months postoperatively. The range of motion (ROM) of the overall cervical spine (C2-7) and the adjacent segments was measured. Results: Group I showed a superior NDI at 18 months postoperatively (p<0.05). The mean C2-7 ROM of bothgroups recovered to thepreoperative ROM. At 18 months postoperatively, the C2-7 ROM of group I was higher than that of group II (p<0.05). The superior adjacent segment ROM was higher in group II (p<0.05), starting at 6 months. The inferior adjacent segment ROM showed no significant difference between the groups (p>0.05). Conclusions: The HC group showed comparable clinical and radiographic outcomes to those of the 2-level ACDF group. HC can be used selectively in the treatment of patients with 2-level cervical disc disease.

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* 2021년 이후 발행 논문의 참고문헌은 현재 구축 중입니다.

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