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Neck Disc Offers Good Results After Earlier Fusion

Results with artificial disc similar after primary surgery and following prior cervical fusion

TUESDAY, March 31 (HealthDay News) -- Clinical outcomes following placement of an artificial cervical disc were similar in patients with and without previous adjacent cervical fusion, according to research published in the March 15 issue of Spine.

Frank M. Phillips, M.D., of the Rush University Medical Center in Chicago, and colleagues analyzed data from adults with single-level cervical radiculopathy or myelopathy who received an artificial cervical disc. Twenty-six patients underwent disc placement at a level adjacent to a previous anterior cervical decompression and fusion (ACDF), and 126 did not have previous fusion.

Surgery time and blood loss were similar in the groups, the researchers report. Both groups showed significant improvement in Neck Disability Index and neck and arm Visual Analog Scores following surgery and during periodic follow-ups over two years. However, the adjacent-to-fusion group had a higher rate of reoperation (7.7 percent versus 1.6 percent), the investigators found.

"Managing symptomatic cervical degeneration adjacent to a prior fusion can be challenging. Performing cervical total disc replacement adjacent to a prior ACDF may circumvent complications associated with multilevel and repeat ACDFs," the authors conclude. "The current study suggests that short-term clinical outcomes of cervical disc arthroplasty adjacent to fusion are similar to those of primary disc arthroplasty. Longer follow-up is, however, needed to ascertain if the functional scores maintain, improve, or worsen, or the complications increase over time."

At least one co-author disclosed a relationship to a commercial party related to the article.

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