Evaluation and Comprehensive Analysis of Mid-Term Clinical Outcomes of Motion-Preserving Cervical Disc Prostheses
Abstract
Aim: In our study, we aimed to evaluate parameters such as motion preservation efficacy, heterotopic ossification, and adjacent segment effects by examining the clinical and radiological pre- and postoperative results of 215 patients who underwent motion-preserving cervical disc prosthesis implantation.
Materials and Methods: A retrospective analysis was conducted on 215 patients who underwent anterior cervical discectomy and motion-preserving cervical disc prosthesis implantation. Demographic characteristics, preoperative and postoperative neck pain, visual analogue scale (VAS, 0-10) score, Neck Disability Index (NDI), SF-36 quality of life questionnaire (physical and mental components), and Odom's criteria were recorded. Direct radiography, MRI, and CT scans were performed.
Results: The difference between patients' preoperative and 24-month VAS scores was significant (p <0.001). The preoperative mean NDI score was 38.4 ± 8.6, while it decreased to 12.7 ± 6.2 at 24 months (p <0.001). Although improvement was more limited in patients with myelopathy, a significant improvement was recorded in both groups (p <0.001). According to the SF-36 questionnaire, the physical component was 42.6 ± 9.4 preoperatively and 73.8 ± 8.1 at 24 months (p <0.001), while the mental component was 45.3 ± 10.2 preoperatively and 76.1 ± 7.9 at 24 months (p <0.001). According to Odom's criteria, 84.7% of patients were satisfied with the results. Radiological results showed that disc height gain was statistically significant (p <0,001). Postoperative segmental lordosis values were significantly higher than preoperative values (p <0.001). The percentage of patients who maintained ≥4° range of motion in segmental mobility was 87.4%, and the number of patients who developed adjacent segment degeneration at 24 months was 19 (8.8%). The complication rate was 8.3%. Two patients required revision surgery.
Conclusion: In our study, patients who underwent cervical disc replacement were evaluated in terms of pain, functional recovery, complications, and quality of life. Our results indicate that the cervical disc prosthesis is an important treatment option and should be considered when making surgical decisions.
Keywords
Cervical disc diseases, Cervical disc prosthesis, Radiculopathy, Anterior cervical discectomy, Neck pain
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