PMID- 35351839
OWN - NLM
STAT- MEDLINE
DCOM- 20220506
LR  - 20230831
IS  - 2380-0194 (Electronic)
IS  - 2380-0186 (Linking)
VI  - 35
IP  - 4
DP  - 2022 May 1
TI  - Surgical Treatment of Single Level Cervical Radiculopathy: A Comparison of 
      Anterior Cervical Decompression and Fusion (ACDF) Versus Cervical Disk 
      Arthroplasty (CDA) Versus Posterior Cervical Foraminotomy (PCF).
PG  - 149-154
LID - 10.1097/BSD.0000000000001316 [doi]
AB  - STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: The objective of 
      this study is to retrospectively compare the clinical outcomes, complication 
      rates, and reoperation rates among the 4 treatments in patients with cervical 
      radiculopathy. SUMMARY OF BACKGROUND DATA: Surgical options for cervical 
      radiculopathy include anterior cervical discectomy and fusion (ACDF), open 
      posterior cervical foraminotomy (O-PCF), minimally invasive posterior cervical 
      foraminotomy (MI-PCF), and cervical disk arthroplasty (CDA). MATERIALS AND 
      METHODS: Retrospective chart review after Review Board approval. Of the 384 
      patients in the study-257 ACDF, 18 O-PCF, 52 MI-PCF, and 56 CDA. Information was 
      obtained from the charts and compared between the groups. PATIENT SAMPLE: 
      Patients above 18 years of age with single-level, unilateral cervical 
      radiculopathy correlating with magnetic resonance imaging, failure of 
      nonoperative management, and 1-level ACDF, O-PCF, MI-PCF, or CDA with >24 months 
      of follow-up. OUTCOME MEASURES: Neck Disability Index (NDI), Visual Analog Score 
      neck and arm pain, minimum clinically significant difference (MCID), complication 
      rates, and reoperation rates. RESULTS: Operative time was significantly shorter 
      for MI-PCF. Median estimated blood loss was small, but greater with O-PCF 
      compared with other interventions. The length of hospital stay was longest for 
      the ACDF group. At 2 years' follow-up, 36 subjects (9%) had subsequent neck 
      surgery. The most common indication for additional surgery was recurrent symptoms 
      (3.4%) followed by adjacent segment disease (2.6%), pseudoarthrosis (2.1%), 
      adjacent segment disease + pseudoarthrosis (0.5%), and implant-related 
      complications (0.3%). There was no statistically significant difference in 
      complication rates between groups. MCID in NDI was achieved in 40% of MI-PCF 
      subjects, 42% of O-PCF subjects, 66% of CDA subjects and 46% of ACDF subjects. 
      CONCLUSIONS: All 4 treatment options confer good clinical results on patients for 
      cervical radiculopathy. Intraoperative and postoperative complications were low 
      and comparable in all 4 groups. MI-PCF had the shortest surgical time and length 
      of hospital stay. More CDA patients achieved MCID in NDI compared with the 
      others, and the rate for additional surgery at 2 years was lowest in the CDA 
      group.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Padhye, Kedar
AU  - Padhye K
AD  - Twin Cities Spine Center, Minneapolis, MN.
FAU - Shultz, Paul
AU  - Shultz P
FAU - Alcala, Christopher
AU  - Alcala C
FAU - Mehbod, Amir
AU  - Mehbod A
FAU - Garvey, Timothy
AU  - Garvey T
FAU - Schwender, James
AU  - Schwender J
FAU - Dawson, John M
AU  - Dawson JM
FAU - Transfeldt, Ensor
AU  - Transfeldt E
LA  - eng
PT  - Journal Article
DEP - 20220330
PL  - United States
TA  - Clin Spine Surg
JT  - Clinical spine surgery
JID - 101675083
SB  - IM
MH  - Arthroplasty
MH  - Cervical Vertebrae/surgery
MH  - Decompression
MH  - Diskectomy/adverse effects
MH  - *Foraminotomy/methods
MH  - Humans
MH  - Infant
MH  - Postoperative Complications/etiology/surgery
MH  - *Pseudarthrosis/surgery
MH  - *Radiculopathy/etiology/surgery
MH  - Retrospective Studies
MH  - *Spinal Fusion/methods
MH  - Treatment Outcome
COIS- The authors declare no conflict of interest.
EDAT- 2022/03/31 06:00
MHDA- 2022/05/07 06:00
CRDT- 2022/03/30 05:40
PHST- 2022/01/24 00:00 [received]
PHST- 2022/03/01 00:00 [accepted]
PHST- 2022/03/31 06:00 [pubmed]
PHST- 2022/05/07 06:00 [medline]
PHST- 2022/03/30 05:40 [entrez]
AID - 01933606-202205000-00004 [pii]
AID - 10.1097/BSD.0000000000001316 [doi]
PST - ppublish
SO  - Clin Spine Surg. 2022 May 1;35(4):149-154. doi: 10.1097/BSD.0000000000001316. 
      Epub 2022 Mar 30.