Long-term follow-up MRI shows no hastening of adjacent segment degeneration following cervical disc arthroplasty

Sci Rep. 2022 Aug 3;12(1):13318. doi: 10.1038/s41598-022-17652-8.

Abstract

Cervical disc arthroplasty is an established procedure, but studies with data on long-term clinical outcome, reoperation for symptomatic adjacent segment degeneration (sASD), and degenerative changes based on MRI findings are rare. Thus, a file review was performed and patients with complete documentation of neurological status at preoperative, postoperative, 12 month, 3-4 years follow-up including surgical reports for reoperation with a minimum follow-up of 9 years were included. Final follow-up assessment included a physical examination, assessment of pain levels, Odoms criteria, Neck disability index. The degeneration of each cervical segment at preoperative and at final follow-up was assessed using an MRI. Forty-six out of 68 included patients participated, the mean follow-up was 11 (range 9-15) years, at which 71.7% of patients were free of arm pain, 52.2% of patients were free of neck pain, 63% of patients had no sensory dysfunction, and full motor strength was noted in 95.6% of patients. The clinical success rate was 76.1%, the mean NDI was 12%. Overall repeated procedure rate was 17%, the reoperation rate for sASD was 9%, and removal of CDA was performed in 4%. MRI showed progressive degeneration but no significant changes of SDI from preoperative to final follow-up.

MeSH terms

  • Arthroplasty / adverse effects
  • Arthroplasty / methods
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Diskectomy / methods
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc Degeneration* / diagnostic imaging
  • Intervertebral Disc Degeneration* / surgery
  • Magnetic Resonance Imaging
  • Spinal Fusion* / adverse effects
  • Spinal Fusion* / methods
  • Treatment Outcome