Neurospine.
2024 Sep;21(3):1040-1050. 10.14245/ns.2448582.291.
Clinical and Radiographic Outcomes of Cervical Disc Replacement Versus Posterior Endoscopic Cervical Decompression: A Matched-Pair Comparison Analysis
- Kotheeranurak V
1,2,3 - Jitpakdee K3
- Lewandrowski KU4
- Lin GX5,6
- Singhatanadgige W1,2
- Limthongkul W1,2
- Yingsakmongkol W1,2
- Kim JS7
- Liawrungrueang W8
- Affiliations
-
- 1Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- 2Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand
- 3Department of Orthopedics, Queen Savang Vadhana Memorial Hospital, Sriracha, Thailand
- 4Departmemt of Orthopaedics, Fundación Universitaria Sanitas, Bogotá, Colombia
- 5Department of Orthopedics, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- 6The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
- 7Spine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 8Department of Orthopaedics, School of Medicine, University of Phayao, Phayao, Thailand
- KMID: 2560336
- DOI: http://doi.org/10.14245/ns.2448582.291
Abstract
Objective
To compare clinical and radiographic outcomes between 2 motion preservation surgeries, cervical disc replacement (CDR) and posterior endoscopic cervical decompression (PECD), for unilateral cervical radiculopathy.
Methods
Between February 2018 and December 2020, 60 patients with unilateral cervical radiculopathy who underwent either CDR or PECD were retrospectively recruited as matched pairs. Clinical outcomes included visual analogue scale (VAS) scores for neck and arm pain, Neck Disability Index (NDI), and satisfaction rates. The radiographic outcome was index level motion. Intraoperative data, complications, and hospital stay were collected. Preoperative and postoperative outcomes were compared.
Results
Patients undergoing CDR or PECD were included, with 30 cases in each group. Matched pairs were compared in terms of demographic data and preoperative measurements. CDR was associated with shorter operative times, whereas PECD resulted in less intraoperative blood loss. The total complication rate was 5%. NDI and VAS for neck and arm were significantly improved in both groups, with no significant differences between the 2 groups. Satisfaction rates of good and excellent exceeded 87% in both groups. CDR was superior to PECD in the restoration of disc height. Early postoperative follow-up showed no significant difference in terms of index level motion. PECD demonstrated significantly shorter hospital stays and quicker return-to-work times (p<0.05).
Conclusion
PECD achieved equivalent clinical and radiologic outcomes compared with CDR when the certain criteria for surgery were met. Both techniques demonstrated the potential to maintain index level motion. Additionally, PECD resulted in less blood loss, shorter hospital stays, and faster return-to-work times. Conversely, CDR offered shorter operative times and better restoration of disc height.
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