Comparison between cervical disc arthroplasty and conservative treatment for patients with single level cervical radiculopathy at C5/6

Int J Surg. 2018 Jun;54(Pt A):124-128. doi: 10.1016/j.ijsu.2018.01.033. Epub 2018 Jan 31.

Abstract

Background: Cervical radiculopathy is a common disease that affects millions of people. Patients usually are managed by conservative therapy and surgical treatments.

Objective: To compare the clinical outcomes between cervical disc arthroplasty (CDA) and conservative management for patients with single level cervical radiculopathy at C5/6.

Methods: Seventy-two patients with cervical radiculopathy that only affect C5/6 joints were included and thirty-two of them received CDA surgery, and forty patients were treated with conservative management. All the patients were followed up around 4 years. Cervical curvature, cervical range of motion (CROM), horizontal displacement of cervical spine, and intervertebral gap were measured by radiological examination.

Results: All the patients have comparable disease severity based on pre-surgical radiological assessments. At the 4-year follow-up examination, patients with CDA surgery had less CROM at C5/6 level, while greater CROM at C4/5 level, than control group. Similarly, the horizontal displacement in CDA group decreased at C5/6 vertebrae, and increased at C4/5 level at the 4-year follow-up examination. The intervertebral gaps of patients in CDA group were larger than control group at one-year and last follow-up examination.

Conclusion: CDA surgery stabilized C5/6 vertebrae and increased the CROM and horizontal displacement of upper adjacent C4/5 vertebrae.

Keywords: Cervical curvature; Cervical disc arthroplasty; Cervical radiculopathy; Cervical spine range of motion; Intervertebral gap; Joint degeneration.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Arthroplasty / methods
  • Arthroplasty / statistics & numerical data*
  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Conservative Treatment / methods
  • Conservative Treatment / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neck / surgery
  • Radiculopathy / diagnostic imaging
  • Radiculopathy / surgery*
  • Radiography
  • Range of Motion, Articular
  • Treatment Outcome