INTERMEDIATE TO LONG-TERM CLINICAL AND RADIOLOGICAL RESULTS OF CERVICAL DISC PROSTHESIS: A COMPARATIVE STUDY WITH ANTERIOR CERVICAL DISCECTOMY AND FUSION

Objective: As an alternative to anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR) has become more popular over time because it is more suitable for cervical biomechanics.The aim of this study was to evaluate the intermediate-to long-term clinical and radiological results of polyetheretherketone cage CDR and compare them with the results of ACDF.Materials and Methods: We retrospectively analyzed 39 cases following single-level CDR and 36 cases following single-level ACDF.Surgical levels treated in both groups included C3-4, C4-5, and C5-6, without any procedure performed on C6-7.Evaluations included adjacent segment disease (ASD), segmental range of motion (ROM), disc height, cervical lordosis, neck disability index (NDI), and the Visual Analogue Scale (VAS).Results: At a mean follow-up of over 5 years, both groups were significantly improved in VAS and NDI (p<0.01).Both groups had an increase in cervical lordosis and disc height, albeit greater in the CDR group (p<0.05).Segmental ROM was maintained in the CDR group (9.0), whereas it was significantly restricted in the ACDF group (1.1, p<0.001).Moreover, the rate of postoperative ASD was significantly lower in the CDR group (2.6%) than that in the ACDF group (16.7%, p=0.03).Heterotopic ossification developed in 10.2% of the CDR group, without any symptomatic manifestations.Two revision surgeries were needed in the ACDF group, whereas none were needed in the CDR group.Conclusion: CDR provides comparable symptom alleviation to ACDF, and also enables greater maintenance of motion, better alignment, and significantly less risk of ASD.