Thursday, September 27, 2018 3:35 PM–5:05 PM Section on Motion Technology Abstract Presentations: 137. How do patients with predominant chronic neck pain experience cervical disc replacement? Results from a prospective study at 5 years follow-up

Abstract

BACKGROUND CONTEXT Several studies have demonstrated that cervical total disc replacement (CTDR) is a safe and effective alternative to anterior cervical discectomy and fusion for the treatment of well-defined cervical pathologies. Nevertheless, data on some specific indications remain in short supply. PURPOSE To compare clinical and radiological outcomes of patients with preoperative predominant chronic neck pain (PCNP) to those without, 5 years after CTDR. STUDY DESIGN/SETTING Patients were from an observational, prospective and multicentric French study (involving eight centers). Exploratory analysis of CTDR patients with predominant chronic neck pain (VAS neck pain >50/100 & VAS neck pain > VAS arm pain) before the surgery, compared to the rest of the population. PATIENT SAMPLE The study enrolled 384 patients and is ongoing up to 10 years. Learning curve cases, patients with previous cervical surgery, patients with severely degenerated discs and work related injuries were not excluded. OUTCOME MEASURES Clinical outcomes (NDI 0-100%, VAS arm and neck pain 0-100 mm, SF-36) were completed prospectively by patients. Radiological outcomes included range of motion at index and adjacent levels, heterotopic ossifications (HO) according to Mehren-McAfee classification, adjacent segment degeneration according to Kellgren-Lawrence classification. Complications and subsurgery were reported. Patient satisfaction, medication consumption and employment status were also completed. METHODS The analysis considers patients treated with 1- or 2-level CTDR. PCNP patients were selected based on VAS pain (VAS neck pain > 50/100 & VAS neck pain > VAS arm pain) and duration of symptoms (>1 year). Mann-Whitney test was applied to compare data between groups and Fisher's exact test was applied to compare proportions. RESULTS For the PCNP group 47 patients were selected and 291 represents the group rest of population (RP). Mean age and mean operative duration were significantly higher for PCNP group. PCNP patients were more likely to be treated with 2-level. For VAS neck pain PCNP patients showed significantly higher improvement at 5-year compared to preoperative baseline (43.9 mm vs. 22.9; p CONCLUSIONS Patients with preoperative predominant chronic neck pain had similar patient-reported clinical and radiological outcomes with better improvement for VAS neck pain up to 5 years after surgery. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.