General Session: Cervical-2
Presented by: A. Berg - View Audio/Video Presentation (Members Only)
S. Friesem(1), S. Khan(1), M. Rajesh(1), A. Berg(1), G. Reddy(1), C. Bhatia(1), K. Aneiba(1)
(1) University Hospital of North Tees, Orthopaedics, Stockton on Tees, United Kingdom
Introduction: We know that reported clinical outcomes for single level and two-level cervical disc arthroplasty are favorable in the literature. But there is paucity of data on grouped comparison of outcomes between 1 & 2-level and 3 & 4-level cervical disc arthroplasty in the literature. We did a retrospective review of prospectively collected data comparing the outcomes in the 2 groups with a minimum 2 year follow up.
Methods: Clinical Outcomes were reviewed on 42 patient with single level, 50 patents with 2-level, 51 patients with 3 & 4-level cervical arthroplasty in our unit. Review of prospectively collected data included NDI (Neck Disability Index), Visual Analogue score for Neck (VAS Neck), and Visual Analogue score for Arm (VAS Arm). Scores were collected pre-operatively and at each follow up at 3 months, 6 months, 1st and yearly afterwards. Two Sample T-test was used to analyse the data for statistical significance.
Results: Duration of symptoms was 51.24 months for 1 and 2 levels patients and for 3 and 4 level patients was 62 months. Patients underwent surgery using NuNec (Pioneer Surgical Technology, USA), Discocerv (Alphatec, USA) and Prestige (Medtronic, USA). The indication for surgery was radiculopathy and myelopathy. The NDI score improved from a mean of 49.69 to 34.95 for 1 & 2 levels and for 3 & 4 levels, it improved from 51.75 to 37.26 (P value: 0.932). The VAS Neck improved from a mean of 7.17 to 4.03 for 1 & 2 levels and for 3 & 4 levels, it improved from 7.08 to 3.80 (P value: 0.839). The mean improvement in VAS Arm scores for 1 & 2 levels were from 6.56 to 3.51 and for 3 & 4 levels were 6.55 to 3.77 (P value: 0.689). There was no statistically significant difference between the 2 groups (p > 0.05) for NDI, VAS Neck and VAS Arm.
Conclusion: Our results suggest that though there was significant improvement in the NDI, VAS Neck and VAS Arm scores, the quantum of improvement was similar in both the groups. There does not seem to be a statistically significant difference between 1 & 2 level and 3 & 4 level cervical arthroplasty. As 1 and 2 level arthroplasty has become widely accepted we believe, that in Multi level pathology, as this study shows multi level arthroplasty is a viable option.