Clinical and Radiological Outcome of Disc Arthroplasty for the Treatment of Cervical Spondylotic Myelopathy

Abstract

Introduction: The aim of this study is to evaluate the clinical and radiological results of cervical disc arthroplasty (CDA) in patients with cervical spondylotic myelopathy (CSM) using the CP ESP® disc prosthesis. Materials and Methods: Prospectively collected data of 56 patients with CSM have been analyzed. The mean age at surgery was 35.6 years (range: 25–43 years). The mean follow-up was 28.2 months (range: 13–42 months). The range of motion (ROM) of the index segments, as well as upper and lower adjacent segments, was measured before surgery and at final follow-up. The C2-C7 sagittal vertical axis (SVA), C2-C7 cervical lordosis (CL), and T1 slope minus cervical lordosis (T1s-CL) were analyzed as well. Pain intensity was measured preoperatively and during follow-up using an 11-point numeric rating scale (NRS). Modified Japanese Orthopaedic Association (mJOA) score was assessed preoperatively and during follow-up for the clinical assessment of myelopathy. Surgical and implant-associated complications were analyzed as well. Results: The NRS pain score improved from a mean of 7.4 (±1.1) preoperatively to a mean of 1.5 (±0.7) at last follow-up (p < 0.001). The mJOA score improved from a mean of 13.1 (±2.8) preoperatively to a mean of 14.8 (±2.3) at last follow-up (p < 0.001). The mean ROM of the index levels increased from 5.2° (±3.0) preoperatively to 7.3° (±3.2) at last follow-up (p < 0.05). Four patients developed heterotopic ossifications during follow-up. One patient developed permanent dysphonia. Conclusions: CDA showed good clinical and radiological outcome in this cohort of young patients. The motion of index segments could be preserved. CDA may be a viable treatment option in selected patients with CSM.