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Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study

INTRODUCTION: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA. RESEARCH QUESTION: Is...

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Autores principales: Pouleau, Henri-Benjamin, De Witte, Olivier, Jodaïtis, Alexandre
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293310/
https://www.ncbi.nlm.nih.gov/pubmed/37383473
http://dx.doi.org/10.1016/j.bas.2023.101734
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author Pouleau, Henri-Benjamin
De Witte, Olivier
Jodaïtis, Alexandre
author_facet Pouleau, Henri-Benjamin
De Witte, Olivier
Jodaïtis, Alexandre
author_sort Pouleau, Henri-Benjamin
collection PubMed
description INTRODUCTION: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA. RESEARCH QUESTION: Is it possible to expand the indications for the implantation of cervical prostheses by adapting the surgical technique, particularly for severe spondylosis, to benefit from the advantages of prostheses over ACDF ? MATERIALS AND METHODS: We propose a prospective two-center study to compare the possible clinical benefit of the placement of a cervical prosthesis with systematic total bilateral uncuscectomy (or uncinectomy) compared to the classical technique of ACDF, particularly for severe spondylosis. Visual analog scales for brachialgia, cervicalgia, and neck disability index were measured before and one year after surgery. Odom’s criteria were assessed one year after surgery. RESULTS: We compared 81 patients treated with CDA and systematic total bilateral uncuscectomy versus 42 patients treated with ACDF for symptomatic radicular or medullary compression. Patients treated with CDA and uncuscectomy showed greater improvements in VASb, VASc, NDI, and Odom’s criteria than those treated with ACDF, with statistically significant results. Moreover, no difference was found between the severe spondylosis subgroup and the non-severe spondylosis subgroup treated with CDA and uncuscectomy. DISCUSSION AND CONCLUSION: This study assessed the value of systematic total bilateral uncuscectomy for cervical arthroplasty. Our prospective clinical results suggest a surgical technique to reduce cervical pain and improve function one year after surgery, even in cases of severe spondylosis.
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spelling pubmed-102933102023-06-28 Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study Pouleau, Henri-Benjamin De Witte, Olivier Jodaïtis, Alexandre Brain Spine Article INTRODUCTION: Cervical disc arthroplasty (CDA) is mainly used in young patients with soft herniated discs and seems to have several advantages over anterior cervical discectomy and fusion (ACDF). Severe spondylosis is common and represents a contraindication for performing CDA. RESEARCH QUESTION: Is it possible to expand the indications for the implantation of cervical prostheses by adapting the surgical technique, particularly for severe spondylosis, to benefit from the advantages of prostheses over ACDF ? MATERIALS AND METHODS: We propose a prospective two-center study to compare the possible clinical benefit of the placement of a cervical prosthesis with systematic total bilateral uncuscectomy (or uncinectomy) compared to the classical technique of ACDF, particularly for severe spondylosis. Visual analog scales for brachialgia, cervicalgia, and neck disability index were measured before and one year after surgery. Odom’s criteria were assessed one year after surgery. RESULTS: We compared 81 patients treated with CDA and systematic total bilateral uncuscectomy versus 42 patients treated with ACDF for symptomatic radicular or medullary compression. Patients treated with CDA and uncuscectomy showed greater improvements in VASb, VASc, NDI, and Odom’s criteria than those treated with ACDF, with statistically significant results. Moreover, no difference was found between the severe spondylosis subgroup and the non-severe spondylosis subgroup treated with CDA and uncuscectomy. DISCUSSION AND CONCLUSION: This study assessed the value of systematic total bilateral uncuscectomy for cervical arthroplasty. Our prospective clinical results suggest a surgical technique to reduce cervical pain and improve function one year after surgery, even in cases of severe spondylosis. Elsevier 2023-04-01 /pmc/articles/PMC10293310/ /pubmed/37383473 http://dx.doi.org/10.1016/j.bas.2023.101734 Text en © 2023 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pouleau, Henri-Benjamin
De Witte, Olivier
Jodaïtis, Alexandre
Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study
title Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study
title_full Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study
title_fullStr Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study
title_full_unstemmed Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study
title_short Cervical disc arthroplasty with systematic total bilateral uncuscectomy - Adapted technique particularly in severe spondylosis: A prospective study
title_sort cervical disc arthroplasty with systematic total bilateral uncuscectomy - adapted technique particularly in severe spondylosis: a prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293310/
https://www.ncbi.nlm.nih.gov/pubmed/37383473
http://dx.doi.org/10.1016/j.bas.2023.101734
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