Valutazione funzionale dopo intervento chirurgico di artrodesi intersomatica e artroprotesi discale del rachide cervicaleValutazione funzionale dopo intervento chirurgico di artrodesi intersomatica e artroprotesi discale del rachide cervicale

Abstract

Background. Anterior cervical discectomy and fusion (ACDF) may be considered to be the gold standard for treatment of symptomatic cervical disc disease (SCDD). However, fusion of the segment may result in progressive degeneration of the adjacent segments. Therefore, dynamic stabilization procedures have been introduced. Among these, artificial disc replacement by disc prosthesis. Purpose. To compare the efficacy of cervical total disc replacement (TDR) with a disc prothesis to anterior cervical discectomy and fusion (ACDF) surgery for the treatment of one-level SCDD between C4 and C7, from a clinical and radiographic point of view. Methods. 55 patients (16 M) with cervical disc surgery (28 TDR and 27 ACDF) were assessed, after a mean of 24 months (SD 14), with a radiographic evaluation of cervical ROM with x-rays  (dynamic projections). Clinical evaluation of current symptoms (cervicobrachial pain, weackness, changes in sensation, dizziness), cervical range of motion (ROM) evaluation and a neurologic examination of the upper limbs were also performed. Results. No significative differences were highlighted in clinical (p=0.26 in the sintomatologic evaluation; p= 0.19 in the ROM evaluation; p=0.05 in the neurologic examination) and radiological evaluation (p=0.20) between patients with ACDF or TDR. Conclusions. Currently surgery of the cervical spine with artroplasty or ACDF leads to similar results in the short time. Further studies are required to assess long time clinical benefits.