Our Summary

This study looked at the 10-year outcomes of two treatments for cervical degenerative disc disease (a condition where the cushioning discs in the neck break down): cervical disc arthroplasty (CDA, a surgery that involves replacing the damaged disc with an artificial one) and anterior cervical discectomy and fusion (ACDF, a procedure that removes the damaged disc and then fuses the bones above and below it).

The researchers found that patients who had CDA reported less neck disability and pain, and needed fewer follow-up surgeries than those who received ACDF. However, the CDA patients scored lower on a Japanese scale that measures overall orthopedic health. While these differences were statistically significant, they were not large enough to be considered clinically important.

In terms of successful neurological outcomes (how well the nervous system functioned after the surgery), there was no significant difference between the two treatments. So, while CDA may have some advantages, both treatments seem to be similarly effective in the long term.

FAQs

  1. What are the two treatments for cervical degenerative disc disease that the study focused on?
  2. How did the outcomes of cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) compare in terms of neck disability, pain, and need for follow-up surgeries?
  3. Was there a significant difference in neurological outcomes between patients who underwent CDA and those who had ACDF?

Doctor’s Tip

One helpful tip a doctor might tell a patient about discectomy is to follow post-operative instructions carefully to ensure proper healing and recovery. This may include restrictions on activities, physical therapy exercises, and medications to manage pain and prevent infection. It’s also important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. By following these guidelines, you can optimize your chances of a successful outcome after discectomy surgery.

Suitable For

Patients who are typically recommended for discectomy include those with severe and persistent neck pain, arm pain, weakness, or numbness that is not responding to conservative treatments such as physical therapy, medications, or injections. Patients with cervical degenerative disc disease, herniated discs, spinal stenosis, or other conditions that are causing nerve compression or spinal cord compression may also be candidates for discectomy. Additionally, patients who have tried other treatments and are still experiencing significant symptoms that are impacting their daily activities and quality of life may be recommended for discectomy. Ultimately, the decision to undergo discectomy should be made in consultation with a spine surgeon or orthopedic specialist who can evaluate the individual patient’s condition and determine the most appropriate treatment approach.

Timeline

Before the discectomy:

  1. Patient experiences symptoms of cervical degenerative disc disease, such as neck pain, arm pain, weakness, and numbness.
  2. Patient undergoes diagnostic tests, such as MRI or X-ray, to confirm the diagnosis.
  3. Patient tries conservative treatments, such as physical therapy or medications, to manage symptoms.
  4. If conservative treatments are ineffective, patient and their healthcare provider decide to proceed with surgery.

After the discectomy:

  1. Patient undergoes either cervical disc arthroplasty (CDA) or anterior cervical discectomy and fusion (ACDF) surgery.
  2. Patient goes through a recovery period, which may involve physical therapy and pain management.
  3. Over time, patient’s symptoms improve as the spine heals and the nerve compression is relieved.
  4. Patient follows up with their healthcare provider for monitoring and potential adjustments to their treatment plan.
  5. Long-term outcomes are assessed, with patients who had CDA reporting less neck disability and pain compared to those who had ACDF. However, both treatments show similar neurological outcomes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy procedure?
  2. How long is the recovery period after a discectomy and what can I expect during this time?
  3. Will I need physical therapy or rehabilitation after the discectomy surgery?
  4. What type of anesthesia will be used during the procedure and what are the potential side effects?
  5. How will the surgery affect my daily activities and ability to work?
  6. Are there any alternative treatments or non-surgical options that I should consider before proceeding with a discectomy?
  7. How often do patients need follow-up surgeries after a discectomy and what are the reasons for these additional procedures?
  8. What can I do to help ensure a successful outcome and minimize the risk of complications after the discectomy surgery?
  9. How experienced are you in performing discectomy procedures and what is your success rate with this type of surgery?
  10. What are the long-term outcomes and expectations for pain relief and function after a discectomy?

Reference

Authors: Quinto ES Jr, Paisner ND, Huish EG Jr, Senegor M. Journal: Spine (Phila Pa 1976). 2024 Apr 1;49(7):463-469. doi: 10.1097/BRS.0000000000004887. Epub 2023 Nov 29. PMID: 38018778