Adjacent-level arthroplasty following cervical fusion

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Surgery

Background:

• Adjacent-level disc degeneration is a common complication after cervical fusion.
• Symptomatic adjacent-level disc disease presents a treatment challenge.
• Cervical arthroplasty's role in preserving motion post-fusion is not well-documented.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of cervical arthroplasty in patients with adjacent-level disc disease post-ACDF.
• To assess the safety and efficacy of artificial cervical disc replacement in this specific patient group.

Main Methods:

• A retrospective analysis of 11 patients who underwent cervical arthroplasty for adjacent-level disease after ACDF.
• Clinical outcomes assessed using Visual Analog Scale (VAS) for pain and Neck Disability Index (NDI).
• Radiological outcomes evaluated via Cobb angle, functional spinal unit (FSU) angle, and range of motion (ROM) on flexion/extension radiographs.

Main Results:

• No major perioperative complications or device failures were reported.
• Significant improvements in VAS and NDI scores for neck and arm pain.
• Statistically significant increases in overall lordosis (Cobb angle) and ROM at the treated level.
• None of the 8 patients with 1-3 year follow-up required re-operation.

Conclusions:

• Cervical disc arthroplasty appears safe with encouraging early clinical results for post-fusion adjacent-level disease.
• Arthroplasty may be a valuable tool for carefully selected patients with this condition.
• Larger studies with long-term follow-up are necessary to confirm these findings.