PMID- 30371602
OWN - NLM
STAT- MEDLINE
DCOM- 20191112
LR  - 20191112
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 31
IP  - 10
DP  - 2018 Dec
TI  - Treatment of Cervical Myelopathy: Long-term Outcomes of Arthroplasty for 
      Myelopathy Versus Radiculopathy, And Arthroplasty Versus Arthrodesis for 
      Myelopathy.
PG  - 420-427
LID - 10.1097/BSD.0000000000000744 [doi]
AB  - STUDY DESIGN: Analysis of 2- and 7-year outcomes from a clinical trial comparing 
      2-level cervical disk arthroplasty (CDA) to anterior cervical discectomy and 
      fusion (ACDF) in 287 patients with radiculopathy alone, and 110 patients with 
      myelopathy alone or myelopathy with radiculopathy. OBJECTIVE: To compare the 
      long-term safety and effectiveness of CDA for myelopathy versus radiculopathy. 
      SUMMARY OF BACKGROUND DATA: CDA for myelopathy is safe and effective in short 
      term. MATERIALS AND METHODS: We analyzed Neck Disability Index (NDI), neck/arm 
      pain, SF-36, neurological status, adverse events (AEs), and secondary surgeries 
      at index and adjacent levels. RESULTS: All groups improved significantly for NDI, 
      neck/arm pain, and physical component summary (PCS) scores from preoperative to 
      postoperative. CDA Myelopathy versus CDA Radiculopathy: 2- and 7-year 
      improvements were not significantly different. The 7-year score improvements for 
      CDA Myelopathy and CDA Radiculopathy were: NDI (37.8 vs. 35.8, P=0.352), neck 
      pain (12.0 vs. 12.1, P=0.477), arm pain (11.6 vs. 9.6, P=0.480), and PCS (14.1 
      vs. 13.7, P=0.863). The 2 groups had similar proportions of patients who 
      maintained or improved their neurological status (87.2% vs. 93.5%, P=0.218), 
      similar rates of serious AEs (54.5% vs. 57.5%, P=0.291) and similar rates of 
      secondary surgeries at index (3.7% vs. 4.4%, P=0.839) and adjacent levels (3.7% 
      vs. 7.6%, P=0.367). CDA Myelopathy versus ACDF myelopathy: 2 and 7-year 
      improvements were not significantly different. The 7-year CDA and ACDF score 
      improvements were: NDI (37.8 vs. 31.1, P=0.147), neck pain (12.0 vs. 10.4, 
      P=0.337), arm pain (11.6 vs. 11.4, P=0.791), and PCS (14.1 vs. 11.2, P=0.363). 
      The 2 groups had statistically similar proportions who maintained or improved 
      their neurological status (87.2% vs. 96.2%, P=0.409), statistically similar 
      overall rates of secondary surgeries at the index levels (3.7% vs. 9.4%, 
      P=0.374), and statistically similar rates of secondary surgeries at adjacent 
      levels (3.7% vs. 15.4%, P=0.088). CDA group demonstrated lower rates of serious 
      AEs than ACDF (54.5% vs. 65.9%, P=0.019). CONCLUSIONS: CDA for myelopathy is a 
      safe and effective long-term treatment.
FAU - Gornet, Matthew F
AU  - Gornet MF
AD  - The Orthopedic Center of St. Louis, St Louis, MO.
FAU - McConnell, Jeffrey R
AU  - McConnell JR
AD  - OAA Orthopaedic Specialists, Allentown, PA.
FAU - Riew, K Daniel
AU  - Riew KD
AD  - Department of Orthopaedic Surgery, Columbia University Medical Center, New York, 
      NY.
FAU - Lanman, Todd H
AU  - Lanman TH
AD  - California Spine Group, Century City Hospital, Los Angeles, CA.
FAU - Burkus, J Kenneth
AU  - Burkus JK
AD  - Wilderness Spine Services, Columbus, GA.
FAU - Hodges, Scott D
AU  - Hodges SD
AD  - Center for Sports Medicine and Orthopedics, Chattanooga, TN.
FAU - Dryer, Randall F
AU  - Dryer RF
AD  - Central Texas Spine Institute, Austin, TX.
FAU - Copay, Anne G
AU  - Copay AG
AD  - SPIRITT Research, St. Louis, MO.
FAU - Schranck, Francine W
AU  - Schranck FW
AD  - SPIRITT Research, St. Louis, MO.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Arthroplasty
MH  - *Cervical Vertebrae
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Radiculopathy
MH  - Spinal Cord Diseases/*surgery
MH  - Spinal Fusion
MH  - Treatment Outcome
EDAT- 2018/10/30 06:00
MHDA- 2019/11/13 06:00
CRDT- 2018/10/30 06:00
PHST- 2018/10/30 06:00 [pubmed]
PHST- 2019/11/13 06:00 [medline]
PHST- 2018/10/30 06:00 [entrez]
AID - 10.1097/BSD.0000000000000744 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2018 Dec;31(10):420-427. doi: 10.1097/BSD.0000000000000744.