An Eight-Year Follow-Up Study on the Treatment of Single-Level Cervical Spondylosis Through Intervertebral Disc Replacement and Anterior Cervical Decompression and Fusion

Objective To compare the efficacy and safety of the postoperative long-term effect of the treatment of single-level cervical spondylosis through anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR). Methods This is a retrospective contrastive study, which was conducted for the period of January 2007 and January 2009 at the Department of Spine Surgery of the First Affiliated Hospital of Xinjiang Medical University. A total of 113 patients were divided into two groups depending on the operation method: ACDF group (fusion group, n = 66) and ACDR group (replacement group, n = 47). The ACDR group comprised of 23 males and 24 females. The age of these patients ranged from 31-60 years, with an average age of 42.89 +/- 6.30 years. The ACDF group comprised of 38 males and 28 females. The age of these patients ranged from 28-73 years old, with an average age of 49.38 +/- 9.89 years old. The evaluation index included the visual analogue scale (VAS), neck disability index (NDI), range of motion, dysphagia, adjacent vertebral disease, and related complications (prosthesis displacement, heterotopic ossification, etc.). Results A total of 113 patients met the inclusion criteria, and these patients receive more than 96 months of follow-up. The VAS and NDI of these two groups of patients significantly improved, when compared with those before the operation. In the last follow-up visit, the range of motion in the ACDR group and ACDF group was 43.22 +/- 3.58 and 32.54 +/- 2.82, respectively, and both are significantly different comparing to the values measured before the operation (P < 0.05). The dysphagia incidence of the ACDR group was higher than that of the ACDF group at the 36th month, but was lower than that of the ACDF group in other points time. In the last follow-up visit, six patients (12.77%) in the ACDR group and 18 patients (27.27%) in the ACDF suffered from adjacent segment degeneration (ASD). The general complication rate in the replacement group and fusion group was 38.31% and 37.88%, respectively, but the difference between the two groups was not statistically significant (P > 0.05). Conclusion Overall, the clinical efficacy and related complication rate of single-level cervical spondylosis after an anterior cervical approach operation was superior in the ACDR group when compared to the ACDF group.