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Comparison between single- and multi-level patients: clinical and radiological outcomes 2 years after cervical disc replacement

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Abstract

In cervical multi-level degenerative pathology, considering the morbidity of the extensive fusion techniques, some authors advocate for the multilevel disc replacement. This study compared the safety and efficacy of disc replacement with an unconstrained prosthesis in multi- versus single-level patients. A total of 231 patients with cervical degenerative disc disease (DDD) who were treated with cervical disc replacement and completed their 24 months follow-up were analyzed prospectively: 175 were treated at one level, 56 at 2 levels or more. Comparison between both groups was based on usual clinical and radiological outcomes [Neck Disability Index (NDI), Visual Analog Scale (VAS), Range of Motion, satisfaction]. Safety assessments, including complication and subsequent surgeries, were also documented and compared. Mean NDI and VAS scores for neck and arm pain were improved in both groups similarly. Improvement of mobility at treated segments was also similar. Nevertheless, in the multi-level group, analgesic use was significantly higher and occurrence of Heterotopic Ossification significantly lower than in the single-level group. Subject satisfaction was nearly equal, as 94.2% of single-level group patients would undergo the surgery again versus 94.5% in the multi-level group. The overall success rate did not differ significantly. Multi-level DDD is a challenging indication in the cervical spine. This study showed no major significant clinical difference between the two groups. We need further studies to know more about the impact of multi-level arthroplasty, especially on the adjacent segments, but these results demonstrate initial safety and effectiveness in this patient sample.

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The author(s) has/have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this manuscript.

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Authors and Affiliations

  1. Neuro-surgery Department, Clinique du Parc, St-Priest-en-Jarez, France

    J. Huppert

  2. Neuro-surgery Department, University Hospital, Dijon, France

    J. Beaurain

  3. Orthopaedic Surgery Department, University Hospital, Strasbourg, France

    J. P. Steib

  4. Orthopaedic Surgery Department, Centre Aquitain du Dos, Mérignac, France

    P. Bernard

  5. Neuro-surgery Department, Regional Hospital, Orléans, France

    T. Dufour

  6. Orthopaedic Surgery Department, Nice Spine Center, Nice, France

    I. Hovorka

  7. Neuro-surgery Department, Regional Hospital, Orléans, France

    J. Stecken

  8. Neuro-surgery Department, University Hospital, Brest, France

    P. Dam-Hieu

  9. Neuro-surgery Department, Clinique du Millénaire, Montpellier, France

    J. M. Fuentes

  10. Orthopaedic Surgery Department, University Hospital, Bordeaux, France

    J. M. Vital

  11. LDR Médical, Troyes, France

    T. Vila & L. Aubourg

Authors
  1. J. Huppert
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  2. J. Beaurain
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  3. J. P. Steib
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  4. P. Bernard
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  5. T. Dufour
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  6. I. Hovorka
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  7. J. Stecken
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  8. P. Dam-Hieu
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  9. J. M. Fuentes
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  10. J. M. Vital
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  11. T. Vila
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  12. L. Aubourg
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Corresponding author

Correspondence to T. Vila.

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Huppert, J., Beaurain, J., Steib, J.P. et al. Comparison between single- and multi-level patients: clinical and radiological outcomes 2 years after cervical disc replacement. Eur Spine J 20, 1417–1426 (2011). https://doi.org/10.1007/s00586-011-1722-9

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  • DOI: https://doi.org/10.1007/s00586-011-1722-9

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