Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome

Background Data: In spite of being successful, anterior cervical discectomy and fusion ACDF has some complications, among them, pseudoarthrosis, implant failure, and adjacent level disease. Dynamic Cervical Implants (DCI) are motion-preserving implants started to take part in treating cervical spond...

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Autores principales:	Moataz A Elawady, MD., Ramy Taema, MD., Mahmoud M Wahdan, MD.
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2020
Materias:	acdf dci cervical spondylosis radiculopathy myelopathy Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f2bef18489f34541b8ceb872b83e9470
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spelling	oai:doaj.org-article:f2bef18489f34541b8ceb872b83e94702021-12-02T08:11:17ZDynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome10.21608/esj.2020.21585.11172314-89502314-8969https://doaj.org/article/f2bef18489f34541b8ceb872b83e94702020-01-01T00:00:00Zhttps://www.esj.journals.ekb.eg/article_93884_6b88b2967216acb40a3dc5a2e08d9a67.pdfhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: In spite of being successful, anterior cervical discectomy and fusion ACDF has some complications, among them, pseudoarthrosis, implant failure, and adjacent level disease. Dynamic Cervical Implants (DCI) are motion-preserving implants started to take part in treating cervical spondylotic disease with promising results. Purpose: To compare the clinical and radiographic outcomes of ACDF versus DCI in patients with degenerative cervical radiculo- and/or myelopathy. Study Design: A prospective randomized controlled study. Patients and Methods: Forty patients with cervical spondylotic radiculo- and/or myelopathy were recruited for this study. They were 21 males and 19 females with mean age of 45±8.9 years. They were randomly allocated for either the ACDF group including 20 patients undergoing ACDF using PEEK cages or the DCI group including 20 patients using DCI. Clinical outcome parameters were brachialgia VAS and NDI, and radiological outcome parameters were fusion rate, adjacent level changes, and segmental mobility. Results: The mean follow-up was 20±4 months. The mean VAS of brachialgia decreased from 8.7 preoperatively to 6.6 postoperatively in ACDF group, while it decreased from 8.8 to 6.4 in DCI with no significant differences in both groups. The mean NDI improved from 24.7±1.6 to 16.2±1.8 in ACDF group and from 23.9±2.1 to 15.8±2.0 in DCI group, with no significant difference in both groups. Fusin rate was 100% in ACDF group. Radiologically, adjacent level changes were reported in 5 (25%) patients in ACDF group, while these changes were only observed in 1 patient (5%) of the DCI group. Segmental mobility was preserved in all patients in the DCI group but was lost in 3 patients at final follow-up visit. Conclusion: Although clinical outcomes of both ACDF and DCI groups were not significantly different at final follow-up, radiographic parameters were relatively better in DCI group compared to ACDF group including segmental mobility preservation and adjacent level changes. (2019ESJ198) Moataz A Elawady, MD.Ramy Taema, MD.Mahmoud M Wahdan, MD.Egyptian Spine Associationarticleacdfdcicervical spondylosisradiculopathymyelopathyNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 33, Iss 1, Pp 45-53 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	acdf dci cervical spondylosis radiculopathy myelopathy Neurology. Diseases of the nervous system RC346-429
spellingShingle	acdf dci cervical spondylosis radiculopathy myelopathy Neurology. Diseases of the nervous system RC346-429 Moataz A Elawady, MD. Ramy Taema, MD. Mahmoud M Wahdan, MD. Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome
description	Background Data: In spite of being successful, anterior cervical discectomy and fusion ACDF has some complications, among them, pseudoarthrosis, implant failure, and adjacent level disease. Dynamic Cervical Implants (DCI) are motion-preserving implants started to take part in treating cervical spondylotic disease with promising results. Purpose: To compare the clinical and radiographic outcomes of ACDF versus DCI in patients with degenerative cervical radiculo- and/or myelopathy. Study Design: A prospective randomized controlled study. Patients and Methods: Forty patients with cervical spondylotic radiculo- and/or myelopathy were recruited for this study. They were 21 males and 19 females with mean age of 45±8.9 years. They were randomly allocated for either the ACDF group including 20 patients undergoing ACDF using PEEK cages or the DCI group including 20 patients using DCI. Clinical outcome parameters were brachialgia VAS and NDI, and radiological outcome parameters were fusion rate, adjacent level changes, and segmental mobility. Results: The mean follow-up was 20±4 months. The mean VAS of brachialgia decreased from 8.7 preoperatively to 6.6 postoperatively in ACDF group, while it decreased from 8.8 to 6.4 in DCI with no significant differences in both groups. The mean NDI improved from 24.7±1.6 to 16.2±1.8 in ACDF group and from 23.9±2.1 to 15.8±2.0 in DCI group, with no significant difference in both groups. Fusin rate was 100% in ACDF group. Radiologically, adjacent level changes were reported in 5 (25%) patients in ACDF group, while these changes were only observed in 1 patient (5%) of the DCI group. Segmental mobility was preserved in all patients in the DCI group but was lost in 3 patients at final follow-up visit. Conclusion: Although clinical outcomes of both ACDF and DCI groups were not significantly different at final follow-up, radiographic parameters were relatively better in DCI group compared to ACDF group including segmental mobility preservation and adjacent level changes. (2019ESJ198)
format	article
author	Moataz A Elawady, MD. Ramy Taema, MD. Mahmoud M Wahdan, MD.
author_facet	Moataz A Elawady, MD. Ramy Taema, MD. Mahmoud M Wahdan, MD.
author_sort	Moataz A Elawady, MD.
title	Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome
title_short	Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome
title_full	Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome
title_fullStr	Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome
title_full_unstemmed	Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome
title_sort	dynamic cervical implants (dci) versus anterior cervical discectomy and fusion (acdf) in single-level cervical disc disease (cdd): clinical and radiographic outcome
publisher	Egyptian Spine Association
publishDate	2020
url	https://doaj.org/article/f2bef18489f34541b8ceb872b83e9470
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Dynamic Cervical Implants (DCI) versus Anterior Cervical Discectomy and Fusion (ACDF) in Single-Level Cervical Disc Disease (CDD): Clinical and Radiographic Outcome

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