An article published in Spine examines cervical artificial disc replacements and follows patients for 30 years.
The study includes 37 patients who underwent cervical artificial disc replacement between 1980 and 1985 at Changzheng Hospital in China. The patients were young — average age was 30. There were 21 patients who had a 30 year follow-up. Here were findings from the study:
• All 21 patients reported improvement from their preoperative neurological symptoms.
• The last follow up showed 73 percent of the segments maintained motion preservation.
• None of the patients reported symptomatic adjacent segment degeneration at 30 years.
• 90 percent of the patients presented heterotopic ossification, but none underwent reoperation correlated with the heterotopic ossification.
• There were not any device-related adverse events.
"We consider this procedure is worth applying to [young patients]," reported the study authors. "However, whether this procedure can prevent adjacent segment degeneration will require further investigation."
Artificial disc replacement technology has developed significantly over the past three decades. The goal is to preserve the natural motion of the spine and potentially avoid adjacent segment disease, which is a common among spinal fusion patients. Recent studies show disc replacement is at least as good as fusion in the short term, and has potential long term benefits as well.
Cost-effectiveness is also important in healthcare today and a study comparing anterior cervical discectomy and fusion with cervical disc replacement shows the disc replacement procedure had a lower cost to society than fusion. The cost per QALY for disc replacement was $3,042 which is significantly lower than $8,760 for ACDF. Savings could be even higher if the procedure is performed in an ambulatory surgery center.
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