PMID- 35213422 OWN - NLM STAT- MEDLINE DCOM- 20220329 LR - 20220531 IS - 2380-0194 (Electronic) IS - 2380-0186 (Linking) VI - 35 IP - 2 DP - 2022 Mar 1 TI - Anterior Cervical Discectomy and Fusion Versus Cervical Disc Replacement in Patients With Significant Cervical Spondylosis. PG - E327-E332 LID - 10.1097/BSD.0000000000001250 [doi] AB - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aim was to compare clinical outcomes in patients with significant cervical spondylosis treated with cervical disc replacement (CDR) compared with anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: As CDR utilization has increased over the past decade, recent studies have investigated the outcomes of CDR in patients with more significant spondylotic changes and demonstrated improved postoperative patient-reported outcomes (PROs). However, no prior study has investigated clinical outcomes of patients with significant spondylotic changes treated with CDR in comparison to ACDF. METHODS: Patients who underwent 1-level or 2-level CDR or ACDF with significant cervical spondylosis, quantified using a validated grading scale, were identified, and prospectively collected data was retrospectively reviewed. The following PROs were analyzed: Neck Disability Index (NDI), visual analog scale-Neck, visual analog scale-Arm, and PROMIS Physical Function (PROMIS-PF) Computer Adaptive Test Score. Demographic, operative, and radiographic variables, and achievement of minimum clinically important difference (MCID) for each PRO were compared between the 2 groups. RESULTS: A total of 66 patients were included in the present study, of which 35 (53%) were treated with CDR and 31 (47%) with ACDF. The preoperative cervical spondylotic grade was similar between the 2 groups (1.8 vs. 2.2, P=0.27). At final follow-up, there was no significant difference in the absolute value for each PRO between the 2 groups (P>0.19) and both groups demonstrated significant improvement in each PRO compared with preoperative values (P<0.01). There was no significant difference in the percentage of patients achieving the MCID for each PRO when comparing CDR to ACDF (P>0.09). CONCLUSIONS: A similar percentage of patients with significant degenerative cervical spondylosis achieved the MCID across multiple PROs when treated with CDR or ACDF. Patients in both treatment groups demonstrated significant improvement in all PROs assessed when compared with preoperative values. LEVEL OF EVIDENCE: Level III. CI - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved. FAU - Alluri, Ram Kiran AU - Alluri RK AD - Hospital for Special Surgery, New York, NY. FAU - Vaishnav, Avani S AU - Vaishnav AS AD - Hospital for Special Surgery, New York, NY. FAU - Fourman, Mitchell S AU - Fourman MS AD - Hospital for Special Surgery, New York, NY. FAU - Sivaganesan, Ahilan AU - Sivaganesan A AD - Hospital for Special Surgery, New York, NY. FAU - Lee, Ryan AU - Lee R AD - Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC. FAU - Urakawa, Hikari AU - Urakawa H AD - Hospital for Special Surgery, New York, NY. FAU - Mok, Jung Kee AU - Mok JK AD - Weill Cornell Medical College, New York, NY. FAU - Sato, Kosuke AU - Sato K AD - Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba, Japan. FAU - Albert, Todd A AU - Albert TA AD - Hospital for Special Surgery, New York, NY. AD - Weill Cornell Medical College, New York, NY. FAU - Huang, Russel C AU - Huang RC AD - Hospital for Special Surgery, New York, NY. AD - Weill Cornell Medical College, New York, NY. FAU - Sheha, Evan D AU - Sheha ED AD - Hospital for Special Surgery, New York, NY. AD - Weill Cornell Medical College, New York, NY. FAU - Gang, Catherine Himo AU - Gang CH AD - Hospital for Special Surgery, New York, NY. FAU - Qureshi, Sheeraz A AU - Qureshi SA AD - Hospital for Special Surgery, New York, NY. AD - Weill Cornell Medical College, New York, NY. LA - eng PT - Journal Article PL - United States TA - Clin Spine Surg JT - Clinical spine surgery JID - 101675083 SB - IM MH - Cervical Vertebrae/diagnostic imaging/surgery MH - Diskectomy/adverse effects MH - Humans MH - Retrospective Studies MH - *Spinal Fusion/adverse effects MH - *Spondylosis/diagnostic imaging/surgery MH - Treatment Outcome COIS- T.A.A: Royalties from Zimmer Biomet, DePuy Synthes Spine; Consulting Fees from Nuvasive, DePuy Synthes; Book Royalties from JP Medical Publishers, Thieme Medical Publishers, Springer, Elsevier Inc.; Ownership Interests in Innovative Surgical Designs Inc., Bonovo Orthopedics Inc., InVivo Therapeutics, Spinicity, CytoDyn Inc., Paradigm Spine, HS2 LLC, Strathspey Crown, Surg.IO LLC, Augmedics, Morphogenesis, Precision Orthopedics, Pulse Equity, Physician Recommended Neutriceuticals, Parvizi Surgical Innovations; Board member/Other office: Back Story LLC, Scoliosis Research Society, Spine Universe, American Orthopaedic Association. S.A.Q.: Consulting: Globus Medical, Inc., Stryker K2M, Paradigm Spine (Past relationship); Royalties: Globus Medical Inc., Stryker K2M; Private Investments: Tissue Differentiation Intelligence, Vital 5 (Past relationship); Scientific Advisory Board: Healthgrades (Past relationship), Lifelink.Com Inc., Spinal Simplicity, LLC; Speaking and/or Teaching Arrangements: AMopportunities, Globus Medical, Inc., RTI Surgical Inc.; Trips/Travel: Globus Medical, Inc., Integrity Implants Inc., Medical Device Business Services, Medtronic USA, Inc., Nuvasive, Inc., Paradigm Spine, Stryker K2M; Board of Directors: Society Of Minimally Invasive Spine Surgery; Other Office: Annals Of Translational Medicine (Editorial Board Member), Association Of Bone And Joint Surgeons (Committee Member), Cervical Spine Research Society (Committee Member), Contemporary Spine Surgery (Editorial Board Member), International Society For The Advancement Of Spine Surgery (Committee Member), Lumbar Spine Research Society (Committee Member), Minimally Invasive Spine Study Group (Board Member), North American Spine Society (Committee Member), Simplify Medical, Inc. (Clinical Events Committee Member), Society Of Minimally Invasive Spine Surgery (Committee Member, Board Member). The remaining authors declare no conflict of interest. EDAT- 2022/02/26 06:00 MHDA- 2022/03/30 06:00 CRDT- 2022/02/25 17:15 PHST- 2021/05/06 00:00 [received] PHST- 2021/09/15 00:00 [accepted] PHST- 2022/02/25 17:15 [entrez] PHST- 2022/02/26 06:00 [pubmed] PHST- 2022/03/30 06:00 [medline] AID - 01933606-202203000-00012 [pii] AID - 10.1097/BSD.0000000000001250 [doi] PST - ppublish SO - Clin Spine Surg. 2022 Mar 1;35(2):E327-E332. doi: 10.1097/BSD.0000000000001250.