Radiologic Comparison of Cervical Athroplasty with Cervical Arthrodesis

Lee, Jeong Hoon; Kim, Eun Sang; Eoh, Hwan; Kim, Sang Hyuk

Abstract

OBJECTIVE
The incidence of symptomatic adjacent segment disease appears to occur at a rate of 2% to 3% per year, following anterior cervical discectomy and fusion. Recently, cervical arthroplasty is a preferred procedure to arthrodesis.
METHODS
We performed 16 arthropalsties form January 2005 to December 2006 in the Samsung medical center, using the BRYAN artificial disc and 16 anterior cervical interbody fusions. Radiographic evaluation included flexion and extension roentgenogram images of cervical spine. In the former group, the pre- and postoperative segmental sagittal range of motion(ROM) in the arthroplasty level and the adjacent level were measured. In the later group, the pre- and postoperative segmental sagittal ROM in the adjacent level to the fusion level was measured and the Cobb angles at C2-7(or 6) to ascertain overall cervical alignment was measured in both groups.
RESULTS
There was minimal change in sagittal ROM of whole cervical spine in all patients in the two groups. Sagittal ROM of arthroplaty level were increased 7.581+/-4.222 to 11.512+/-5.398(p<0.05) ROM of adjacent level to arthroplasty level were no significant change pre- and postoperatively. But ROM of adjacent level to arthrodesis level were increased 7.160+/-3.609 to 11.260+/-4.832(p<0.05).
CONCLUSIONS
Artificial disc could maintain ROM of pathologic level and adjacent level to fusion level should replace ROM of pathologic level but adjacent level to arthroplasty level should not replace additional ROM postoperatively. Long-term follow up studies are required to prove its efficacy and its ability to prevent adjacent segment disease.