32. 跳跃式颈椎关节置换术与融合术治疗非连续性颈椎退行性椎间盘病变的疗效比较

IF 2.5 Q3 Medicine

North American Spine Society Journal Pub Date : 2025-07-01 DOI:10.1016/j.xnsj.2025.100726

Chao-Hung Kuo MD, PhD

{"title":"32. 跳跃式颈椎关节置换术与融合术治疗非连续性颈椎退行性椎间盘病变的疗效比较","authors":"Chao-Hung Kuo MD, PhD","doi":"10.1016/j.xnsj.2025.100726","DOIUrl":null,"url":null,"abstract":"<div><h3>BACKGROUND CONTEXT</h3><div>This study investigates the clinical and radiological outcomes of skip-level cervical surgeries, comparing cervical arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) approaches in treating noncontiguous cervical degenerative disc disease. It focuses on the incidence of adjacent segment disease (ASD) and evaluates the motion-preserving efficacy of CDA in this context.</div></div><div><h3>PURPOSE</h3><div>N/A</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>A retrospective analysis was conducted on 70 patients with non-contiguous cervical degenerative disc disease who underwent skip-level anterior cervical surgeries (37 ACDF and 33 CDA cases). Demographic, clinical, and radiological data were assessed over a 2-year follow-up period. Cervical lordosis, range of motion (ROM), and ASD rates were compared between the two groups. Statistical analyses were performed to determine significant differences.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 70 patients with noncontiguous cervical degenerative disc disease who underwent skip-level anterior cervical surgeries (37 ACDF and 33 CDA cases) were included.</div></div><div><h3>OUTCOME MEASURES</h3><div>Demographic, clinical, and radiological data were assessed over a 2-year follow-up period. Cervical lordosis, ROM, and ASD rates were compared between the two groups. Statistical analyses were performed to determine significant differences.</div></div><div><h3>METHODS</h3><div>N/A</div></div><div><h3>RESULTS</h3><div>The ASD rate was significantly lower in the CDA group (18.2%) compared to the ACDF group (40.5%, p = 0.04). Postoperative cervical ROM and skip-level ROM were significantly higher in the CDA group than in the ACDF group (p = 0.01 and p = 0.04, respectively). Both techniques restored cervical lordosis, but the fusion group exhibited a significant reduction in overall cervical ROM (p = 0.01), unlike the CDA group, which preserved motion.</div></div><div><h3>CONCLUSIONS</h3><div>Skip-level CDA is a motion-preserving surgical alternative with a lower ASD incidence and better cervical and skip-level ROM compared to ACDF. These findings highlight the benefits of CDA in addressing the challenges of non-contiguous cervical degenerative disc disease while maintaining cervical mobility. Future prospective studies are recommended to validate these results.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>","PeriodicalId":34622,"journal":{"name":"North American Spine Society Journal","volume":"22 ","pages":"Article 100726"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"32. Comparative outcomes of skip-level cervical arthroplasty and fusion in noncontiguous cervical degenerative disc disease\",\"authors\":\"Chao-Hung Kuo MD, PhD\",\"doi\":\"10.1016/j.xnsj.2025.100726\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>BACKGROUND CONTEXT</h3><div>This study investigates the clinical and radiological outcomes of skip-level cervical surgeries, comparing cervical arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) approaches in treating noncontiguous cervical degenerative disc disease. It focuses on the incidence of adjacent segment disease (ASD) and evaluates the motion-preserving efficacy of CDA in this context.</div></div><div><h3>PURPOSE</h3><div>N/A</div></div><div><h3>STUDY DESIGN/SETTING</h3><div>A retrospective analysis was conducted on 70 patients with non-contiguous cervical degenerative disc disease who underwent skip-level anterior cervical surgeries (37 ACDF and 33 CDA cases). Demographic, clinical, and radiological data were assessed over a 2-year follow-up period. Cervical lordosis, range of motion (ROM), and ASD rates were compared between the two groups. Statistical analyses were performed to determine significant differences.</div></div><div><h3>PATIENT SAMPLE</h3><div>A total of 70 patients with noncontiguous cervical degenerative disc disease who underwent skip-level anterior cervical surgeries (37 ACDF and 33 CDA cases) were included.</div></div><div><h3>OUTCOME MEASURES</h3><div>Demographic, clinical, and radiological data were assessed over a 2-year follow-up period. Cervical lordosis, ROM, and ASD rates were compared between the two groups. Statistical analyses were performed to determine significant differences.</div></div><div><h3>METHODS</h3><div>N/A</div></div><div><h3>RESULTS</h3><div>The ASD rate was significantly lower in the CDA group (18.2%) compared to the ACDF group (40.5%, p = 0.04). Postoperative cervical ROM and skip-level ROM were significantly higher in the CDA group than in the ACDF group (p = 0.01 and p = 0.04, respectively). Both techniques restored cervical lordosis, but the fusion group exhibited a significant reduction in overall cervical ROM (p = 0.01), unlike the CDA group, which preserved motion.</div></div><div><h3>CONCLUSIONS</h3><div>Skip-level CDA is a motion-preserving surgical alternative with a lower ASD incidence and better cervical and skip-level ROM compared to ACDF. These findings highlight the benefits of CDA in addressing the challenges of non-contiguous cervical degenerative disc disease while maintaining cervical mobility. Future prospective studies are recommended to validate these results.</div></div><div><h3>FDA Device/Drug Status</h3><div>This abstract does not discuss or include any applicable devices or drugs.</div></div>\",\"PeriodicalId\":34622,\"journal\":{\"name\":\"North American Spine Society Journal\",\"volume\":\"22 \",\"pages\":\"Article 100726\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"North American Spine Society Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666548425001465\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"North American Spine Society Journal","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666548425001465","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

背景背景：本研究探讨了跳跃式颈椎手术的临床和影像学结果，比较了颈椎关节置换术（CDA）和颈前路椎间盘切除术融合术（ACDF）治疗非连续性颈椎退行性椎间盘病变的疗效。它主要关注邻段疾病（ASD）的发病率，并评估CDA在这种情况下的运动保持功效。目的/研究设计/背景回顾性分析70例非连续性颈椎退行性椎间盘病变行跳跃式颈椎前路手术的患者（ACDF 37例，CDA 33例）。在2年的随访期间评估了人口统计学、临床和放射学数据。比较两组患者的颈椎前凸度、活动度（ROM）和ASD发生率。进行统计学分析以确定显著差异。患者SAMPLEA共纳入70例行跳过水平颈椎前路手术的非连续性颈椎退行性椎间盘病变患者（ACDF 37例，CDA 33例）。结果测量：在2年的随访期间评估了人口统计学、临床和放射学数据。比较两组间颈椎前凸、ROM和ASD发生率。进行统计学分析以确定显著差异。方法/结果CDA组ASD发生率（18.2%）显著低于ACDF组（40.5%,p = 0.04）。CDA组术后颈椎ROM和跳跃水平ROM明显高于ACDF组（p = 0.01,p = 0.04）。两种技术都恢复了颈椎前凸，但融合组整体颈椎活动度显著降低（p = 0.01），而CDA组保留了运动。结论与ACDF相比，skip-level CDA具有较低的ASD发生率和较好的颈椎和skip-level ROM，是一种运动保持手术选择。这些发现强调了CDA在解决非连续性颈椎退行性椎间盘疾病挑战的同时保持颈椎活动的益处。建议未来的前瞻性研究来验证这些结果。FDA器械/药物状态本摘要不讨论或包括任何适用的器械或药物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

32. Comparative outcomes of skip-level cervical arthroplasty and fusion in noncontiguous cervical degenerative disc disease

BACKGROUND CONTEXT

This study investigates the clinical and radiological outcomes of skip-level cervical surgeries, comparing cervical arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) approaches in treating noncontiguous cervical degenerative disc disease. It focuses on the incidence of adjacent segment disease (ASD) and evaluates the motion-preserving efficacy of CDA in this context.

PURPOSE

N/A

STUDY DESIGN/SETTING

A retrospective analysis was conducted on 70 patients with non-contiguous cervical degenerative disc disease who underwent skip-level anterior cervical surgeries (37 ACDF and 33 CDA cases). Demographic, clinical, and radiological data were assessed over a 2-year follow-up period. Cervical lordosis, range of motion (ROM), and ASD rates were compared between the two groups. Statistical analyses were performed to determine significant differences.

PATIENT SAMPLE

A total of 70 patients with noncontiguous cervical degenerative disc disease who underwent skip-level anterior cervical surgeries (37 ACDF and 33 CDA cases) were included.

OUTCOME MEASURES

Demographic, clinical, and radiological data were assessed over a 2-year follow-up period. Cervical lordosis, ROM, and ASD rates were compared between the two groups. Statistical analyses were performed to determine significant differences.

METHODS

N/A

RESULTS

The ASD rate was significantly lower in the CDA group (18.2%) compared to the ACDF group (40.5%, p = 0.04). Postoperative cervical ROM and skip-level ROM were significantly higher in the CDA group than in the ACDF group (p = 0.01 and p = 0.04, respectively). Both techniques restored cervical lordosis, but the fusion group exhibited a significant reduction in overall cervical ROM (p = 0.01), unlike the CDA group, which preserved motion.

CONCLUSIONS

Skip-level CDA is a motion-preserving surgical alternative with a lower ASD incidence and better cervical and skip-level ROM compared to ACDF. These findings highlight the benefits of CDA in addressing the challenges of non-contiguous cervical degenerative disc disease while maintaining cervical mobility. Future prospective studies are recommended to validate these results.