Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome

Abstract

Background Data: In spite of being successful, anterior cervical discectomy and fusion ACDF has some complications, among them, pseudoarthrosis, implant failure, and adjacent level disease. Dynamic Cervical Implants (DCI) are motion-preserving implants started to take part in treating cervical spondylotic disease with promising results. Purpose: To compare the clinical and radiographic outcomes of ACDF versus DCI in patients with degenerativecervical radiculo- and/or myelopathy. Study Design: A prospective randomized controlled study. Patients and Methods: Forty patients with cervical spondylotic radiculo- and/or myelopathy were recruited for this study. They were 21 males and 19 females with mean age of 45±8.9 years. They were randomly allocated for either the ACDF group including 20 patients undergoing ACDF using PEEK cages or the DCI group including 20 patients using DCI. Clinical outcome parameters were brachialgia VAS and NDI, and radiological outcome parameters were fusion rate, adjacent level changes, and segmental mobility. Results: The mean follow-up was 20±4 months. The mean VAS of brachialgia decreased from 8.7 preoperatively to 6.6 postoperatively in ACDF group, while it decreased from 8.8 to 6.4 in DCI with no significant differences in both groups. The mean NDI improved from 24.7±1.6 to 16.2±1.8 in ACDF group and from 23.9±2.1 to 15.8±2.0 in DCI group, with no significant difference in both groups. Fusin rate was 100% in ACDF group. Radiologically, adjacent level changes were reported in 5 (25%) patients in ACDF group, while these changes were only observed in 1 patient (5%) of the DCI group. Segmental mobility was preserved in all patients in the DCI group but was lost in 3 patients at final follow-up visit. Conclusion: Although clinical outcomes of both ACDF and DCI groups were not significantly different at final follow-up, radiographic parameters were relatively better in DCI group compared to ACDF group including segmental mobility preservation and adjacent level changes. (2019ESJ198)