Cervical disc arthroplasty vs. ACDF comparison of results in workers compensation cases

The purpose of this study was to assess the outcomes of ACDF and cervical disc arthoplasty for injured workers undergoing surgery for cervical disc herniation and/or spondylosis with radiculopathy.

20 workers compensation patients underwent either ACDF (anterior cervical discectomy and fusion) or cervical disc arthroplasty (anterior cervical discectomy with artificial disc) for disc herniation and/or spondylosis (bone spurring) with neck pain and radiculopathy (arm pain, numbness, and/or weakness).  All patients were operated on by a single surgeon, Jeffrey J. Larson, M.D, CDA Spine, Coeur d’Alene, Idaho.

8 of the 20 patients had single level cervical disc arthroplasty.

8 of the 20 patients had single level ACDF.

4 of the 20 patients had 2 level ACDF.

Neurologic function, Oswestry Disability Index (perceived disability), and return to work rates were measured in every patient.

All patients had normal neurologic function at follow-up.

All patients had improvement in their ODI at follow-up, the rates were 52.6% average improvement for disc arthroplasty cases, 45% improvement for single-level ACDF cases, and 52% improvement for 2 level ACDF cases.

Return to work rates were 40.5 days for disc arthroplasty cases, 96 days for single-level ACDF cases, and 105 days for 2 level ACDF cases.

Interpretation of results:

ACDF and cervical disc arthroplasty both offer excellent outcomes for cervical disc herniation and/or spondylosis with radiculopathy.  Both procedures generally return patients to normal function and regular activities with improvement in perceived disability.  Disc arthroplasty has the benefit of return to regular activities much sooner.  This would significantly decrease time loss in workers compensation cases.

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