Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion
Introduction: In Japan, cervical total disc replacement (TDR) was approved in 2017. However, because of its short history, no comparative study between cervical TDR and anterior cervical discectomy with fusion (ACDF) has been conducted in the country. Therefore, we examined and compared the surgical...
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2022-11-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/6/6/6_2022-0040/_pdf/-char/en |
| _version_ | 1811295483049541632 |
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| author | Kenichiro Sakai Toshitaka Yoshii Yoshiyasu Arai Ichiro Torigoe Hiroyuki Inose Masaki Tomori Takashi Hirai Kyohei Sakaki Yu Matsukura Atsushi Okawa |
| author_facet | Kenichiro Sakai Toshitaka Yoshii Yoshiyasu Arai Ichiro Torigoe Hiroyuki Inose Masaki Tomori Takashi Hirai Kyohei Sakaki Yu Matsukura Atsushi Okawa |
| author_sort | Kenichiro Sakai |
| collection | DOAJ |
| description | Introduction: In Japan, cervical total disc replacement (TDR) was approved in 2017. However, because of its short history, no comparative study between cervical TDR and anterior cervical discectomy with fusion (ACDF) has been conducted in the country. Therefore, we examined and compared the surgical outcomes of TDR and ACDF for one-level cervical degenerative diseases.
Methods: In total, 50 patients who had received anterior surgeries for one-level cervical degenerative diseases were investigated. Among them, 25 underwent TDR (Prestige LP; Medtronic), whereas the other 25 patients underwent ACDF. ACDF samples were selected from cases conducted before the approval of TDR (−2017.9) and were retrospectively judged to be indicated for TDR. Before and at 1 year after surgery, clinical and radiological outcomes were evaluated.
Results: No significant differences in terms of patient demographics between the two groups were observed. A longer operative time was observed in the TDR group than in the ACDF group. Postoperatively, no differences in the Japanese Orthopaedic Association score for cervical myelopathy (C-JOA) score, neck pain visual analog scale, C2-7 angle, and C2-7 range of motion (ROM) were determined. TDR tended to show better neck disability index (NDI) scores postoperatively when compared with ACDF. The local angle at operative level was larger in ACDF. In TDR, the local ROMs were maintained postoperatively; however, in ACDF, the local ROM at the operative level was decreased, and the local ROMs at adjacent levels were increased postoperatively. In the TDR group, although heterotopic ossification was observed in 11 patients (44.0%), and anterior bone loss was identified in 14 patients (56.0%), these issues did not affect surgical outcomes.
Conclusions: Conclusively, no differences in terms of C-JOA score and neck pain between patients treated through TDR and ACDF were observed. However, a trend of better NDI scores was identified with TDR. While TDR maintained postoperative ROMs, ACDF showed an increase in the local ROMs at adjacent levels. |
| first_indexed | 2024-04-13T05:34:03Z |
| format | Article |
| id | doaj.art-866c77d2a4f64099b5d3f51348b758dc |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-04-13T05:34:03Z |
| publishDate | 2022-11-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-866c77d2a4f64099b5d3f51348b758dc2022-12-22T03:00:21ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2022-11-016658158810.22603/ssrr.2022-00402022-0040Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with FusionKenichiro Sakai0Toshitaka Yoshii1Yoshiyasu Arai2Ichiro Torigoe3Hiroyuki Inose4Masaki Tomori5Takashi Hirai6Kyohei Sakaki7Yu Matsukura8Atsushi Okawa9Department of Orthopedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopedic Surgery, Saiseikai Kawaguchi General HospitalDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityDepartment of Orthopedic Surgery, Tokyo Medical and Dental UniversityIntroduction: In Japan, cervical total disc replacement (TDR) was approved in 2017. However, because of its short history, no comparative study between cervical TDR and anterior cervical discectomy with fusion (ACDF) has been conducted in the country. Therefore, we examined and compared the surgical outcomes of TDR and ACDF for one-level cervical degenerative diseases. Methods: In total, 50 patients who had received anterior surgeries for one-level cervical degenerative diseases were investigated. Among them, 25 underwent TDR (Prestige LP; Medtronic), whereas the other 25 patients underwent ACDF. ACDF samples were selected from cases conducted before the approval of TDR (−2017.9) and were retrospectively judged to be indicated for TDR. Before and at 1 year after surgery, clinical and radiological outcomes were evaluated. Results: No significant differences in terms of patient demographics between the two groups were observed. A longer operative time was observed in the TDR group than in the ACDF group. Postoperatively, no differences in the Japanese Orthopaedic Association score for cervical myelopathy (C-JOA) score, neck pain visual analog scale, C2-7 angle, and C2-7 range of motion (ROM) were determined. TDR tended to show better neck disability index (NDI) scores postoperatively when compared with ACDF. The local angle at operative level was larger in ACDF. In TDR, the local ROMs were maintained postoperatively; however, in ACDF, the local ROM at the operative level was decreased, and the local ROMs at adjacent levels were increased postoperatively. In the TDR group, although heterotopic ossification was observed in 11 patients (44.0%), and anterior bone loss was identified in 14 patients (56.0%), these issues did not affect surgical outcomes. Conclusions: Conclusively, no differences in terms of C-JOA score and neck pain between patients treated through TDR and ACDF were observed. However, a trend of better NDI scores was identified with TDR. While TDR maintained postoperative ROMs, ACDF showed an increase in the local ROMs at adjacent levels.https://www.jstage.jst.go.jp/article/ssrr/6/6/6_2022-0040/_pdf/-char/encervical total disc replacementanterior cervical discectomy with fusioncervical degenerative diseases |
| spellingShingle | Kenichiro Sakai Toshitaka Yoshii Yoshiyasu Arai Ichiro Torigoe Hiroyuki Inose Masaki Tomori Takashi Hirai Kyohei Sakaki Yu Matsukura Atsushi Okawa Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion Spine Surgery and Related Research cervical total disc replacement anterior cervical discectomy with fusion cervical degenerative diseases |
| title | Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion |
| title_full | Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion |
| title_fullStr | Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion |
| title_full_unstemmed | Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion |
| title_short | Early Experiences of One-Level Total Disc Replacement (Prestige LP) in Japan: A Comparison of Short-Term Outcomes with Anterior Cervical Discectomy with Fusion |
| title_sort | early experiences of one level total disc replacement prestige lp in japan a comparison of short term outcomes with anterior cervical discectomy with fusion |
| topic | cervical total disc replacement anterior cervical discectomy with fusion cervical degenerative diseases |
| url | https://www.jstage.jst.go.jp/article/ssrr/6/6/6_2022-0040/_pdf/-char/en |
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