Cervical Artificial Disc Replacement
versus Fusion in the Cervical Spine
It has been reported in literature, that Multilevel Cervical Anterior Discectomy and Fusion with Reduction (C-ADR) produced more significant improvements in 1 year in Neck Disability Index and Visual Analog Scale for neck pain compared to Multilevel Anterior Cervical Discectomy and Fusion (ACDF) from the baseline.
However, there is a slight decrease in improvement for VAS arm pain with C-ADR compared to ACDF. After two years, there is a greater improvement from the baseline in NDI and VAS for neck pain with Multilevel C-ADR compared to Multilevel ACDF.
Quality Of Life
Although both the groups show improvements in quality of life, the C-ADR demonstrates a statistically significant higher percentage of improvement.
While there is not much literature on this topic, it is worth noting that there was one reported incidence of deep vein thrombosis in the group that underwent Multilevel C-ADR, and one case of dysphagia in the group that underwent Multilevel ACDF.
There is a higher incidence of heterotopic ossification among patients who underwent single-level C-ADR after two years compared to other groups. Patients who undergo single-level C-ADR may experience a lower incidence of dysphagia compared to those who undergo multilevel C-ADR.
Single-Level Versus Multilevel C-ADR
At four years, the overall and neurological success rates for both single-level and multilevel Cervical Anterior Discectomy and Fusion with Reduction (C-ADR) groups are reported as excellent, while at six years, the results are reported as good.
Function and Pain
In the multilevel C-ADR, the VAS scores for arm and neck pain are observed to be lower in comparison to the single-level C-ADR.
Patient Satisfaction And Return To Work
According to the literature, the percentage of patients who would undergo the same procedure again was reported as 94.2% for single-level Cervical Anterior Discectomy and Fusion with Reduction (C-ADR) and 94.5% for multilevel C-ADR. After two years, 70% of patients who undergo single-level C-ADR and 46% of patients who undergo multilevel C-ADR are able to return to part-time or full-time work.
While the current available literature suggests that Multilevel Cervical Anterior Discectomy and Fusion with Reduction (C-ADR) may have a slight advantage over Anterior Cervical Discectomy and Fusion (ACDF) in the short-term, there is still insufficient evidence to make any definitive treatment recommendations.
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I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.
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