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Motion analysis of dynamic cervical implant stabilization versus anterior discectomy and fusion: a retrospective analysis of 70 cases

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Abstract

Purpose

Retrospective kinematic analysis of treated level, adjacent levels, and overall cervical spine after single-level dynamic cervical implant (DCI) stabilization versus anterior cervical discectomy and fusion (ACDF).

Methods

Between June 2009 and March 2013, 70 consecutive patients with a symptomatic single-level cervical degenerative disk disease (DDD) were enrolled in this study and divided into DCI (n = 35) group and ACDF (n = 35) group. All cases were followed up for more than 5 years. The study compared perioperative parameters; clinical outcomes; and radiological parameters. Kinematic analysis included range of motion (ROM) of treated level and adjacent level, overall ROM (C2–C7), and changes in adjacent disk spaces.

Results

There were no significant differences between the DCI group and ACDF group in terms of improvement in the SF-36, VAS, NDI, and JOA scores. DCI stabilization resulted in better ROM of C2–C7 and the treated level than ACDF did. The ROM of treated level decreased significantly at 24 months after surgery and last follow-up in the DCI group, and the C2–C7 ROM showed different degrees of reduction after the 24 months after surgery. Radiological evidence of adjacent segment degeneration (ASD) at last follow-up was observed in 4/22 patients (18.2%) in the DCI group and 5/23 patients (21.7%) in the ACDF group which was not a significant difference between groups (p > 0.05).

Conclusions

DCI stabilization for the treatment of cervical DDD cannot preserve the normal kinematics of the cervical spine for a long time, especially the treated level. DCI stabilization cannot decrease the risk of ASD compared with ACDF.

Graphical abstract

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Funding

Kindly thanks for the support of the Natural Science Foundation of Liaoning Province (20170540294) and Basic Scientific Research Projects of the Universities in Liaoning Province (LQ2017022). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Author notes

  1. Zhonghai Li, Huarong Wu and Jin Chu contributed equally to the manuscript and should be considered co-first authors.

Authors and Affiliations

  1. Department of Orthopaedics, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China

    Zhonghai Li, Jin Chu & Mozhen Liu

  2. Department of Orthopaedics, Jizhong Energy Xingtai Mining Group General Hospital, Xingtai, People’s Republic of China

    Huarong Wu

  3. Department of Orthopaedics, First Affiliated Hospital of PLA General Hospital, Beijing, People’s Republic of China

    Shuxun Hou

  4. Department of Orthopaedics, Tenth People’s Hospital of TongJi University, Shanghai, People’s Republic of China

    Shunzhi Yu & Tiesheng Hou

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  1. Zhonghai Li
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  4. Mozhen Liu
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Correspondence to Zhonghai Li or Mozhen Liu.

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All authors state that there is no actual or potential of conflicts of interest in relation to this article. All authors declare that there are no any financial and personal relationships with other people or organizations that could inappropriately influence (bias) our work.

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Li, Z., Wu, H., Chu, J. et al. Motion analysis of dynamic cervical implant stabilization versus anterior discectomy and fusion: a retrospective analysis of 70 cases. Eur Spine J 27, 2772–2780 (2018). https://doi.org/10.1007/s00586-018-5755-1

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  • DOI: https://doi.org/10.1007/s00586-018-5755-1

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