Abstract
Background: Anterior Cervical Discectomy and Fusion (ACDF) is an effective treatment for disc herniations; but some studies demonstrated that in the untreated levels adjacent to a fusion, increased motion might lead to an increased risk of adjacent segment degeneration (ASD). On the other hand, methods of cervical Disc Arthroplasty (CDA) have improved. The aim of this study is to evaluate and compare the rate of ASD in patients who underwent ACDF or CDA cervical spine surgery.
 Methods and Materials: This prospective study was performed on 84 patients with cervical radiculopathy due to single-level disc herniation referred to hospitals in Tehran, Iran from June 2011 to December 2012. All subjects were randomly allocated to Group A or Group B to undergo ACDF or CDA, respectively. The validated Neck Disability Index (NDI) questionnaire was used to assess the cervical neck pain.
 Results: The mean of age in Group A was 51.7 ± 9.1 years and in Group B was 49.3 ±9.2. The differences in cervical radiculopathy in the two groups were not statistically significant. The difference in mean Visual Analogue Scale (VAS) score in the two groups at each assessment time was statistically significant. Mean NDI score before the surgery was 46.9 ± 6.1 in group A, and 41.3 ±4.7 in group B. The mean NDI score improved significantly in group B. Twenty-seven of the patients in Group A experienced ASD at 12 months compared to one patient (2.3%) in Group B (p<0.05).
 Conclusion: According to the findings of this study, CDA leads to reduced VAS and NDI score compared to ACDF. Also increased ASD in ACDF was demonstrated when compared with CDA after 1-year follow-up.
Highlights
The technique of a non-fusion operation was developed for preserving movementChronic neck pain is one of the most common musculoskeletal disorders, presentfunctions and reducing physical stress injuring of the adjacent segments
4 Assistant professor and Emergency Medicine, Jundishapur University of Health and Medical Sciences, Ahvaz, Iran f S Abstract o Background: Anterior Cervical Discectomy and Fusion (ACDF) is an effective treatment for disc herniations; but some studies demonstrated that in the untreated levels adjacent to a fusion, e increased motion might lead to an increased risk of adjacent segment degeneration (ASD)
Methods of cervical Disc Arthroplasty (CDA) have improved. The aim of this iv study is to evaluate and compare the rate of ASD in patients who underwent ACDF or CDA cervical spine surgery.Methods and Materials: This prospective study was performed on 84 patients with cervical radiculopathy due to single-level disc herniation referred to hospitals in Tehh ran, Iran from June 2011 to December 2012
Summary
The technique of a non-fusion operation was developed for preserving movement. CDA may decrease can be defined as having high pain intensity the chances of developing ASD and segment with disability.[4] chronic neck pain not breakdown by maintaining normal disc kineonly limits performance, and has a sig- matics.[17] nificant impact on the economy and health.[2,4] few clinical studies have specifi-. S patients.8Usual clinical findings of myelopathy include hyperreflexia, disabling disturf bances of gait, clonus, equilibrium, coordination, and difficulty handling small objects.[9] o The main goal of all treatment techniques is to decompress the affected neural structure, e and to advance fixation techniques as well as motion-preserving options.[10,11] iv In the early twentieth century, cervical radiculopathy symptoms were attributed to compression of the brachial plexus by the h anterior scalene muscle.[12] Anterior Cervical. A represents the standard treatment for cervical with CDA after cervical spine surgery
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