Clinical and radiographic comparison of cervical disc arthroplasty with Prestige-LP Disc and anterior cervical fusion: A minimum 6-year follow-up study

Objectives: To retrospectively compare the long-term clinical and radiographic outcomes of cervical disc arthroplasty (CDA) with Prestige-LP Disc and anterior cervical discectomy and fusion (ACDF) for single-level cervical degenerative disc disease. Patients and methods: Ninety-eight patients (45 CDA and 53 ACDF) with a minimum 6-year follow-up were included. Clinical evaluations included Japanese Orthopedic Association (JOA), visual analogue scale (VAS), and Neck Disability Index (NDI) scores. Radiographic evaluations included sagittal alignment, range of motion (ROM) at the index and adjacent level, adjacent segment degeneration (ASD), and heterotopic ossification (HO). Results: At the final follow-up, there were no significant differences in JOA, VAS neck, and VAS arm scores between the two groups. However, NDI scores improved more in the CDA group than in the ACDF group. The sagittal alignment was maintained in both groups. The ROM at the index level in the CDA group was decreased from 9.6 +/- 4.3 degrees at baseline to 7.8 +/- 4.7 degrees at the final follow-up. The ROM at the cranial adjacent level in the ACDF group was increased. The incidence of ASD was lower in the CDA group than in the ACDF group (26.7% vs 49.1%, p = 0.023). HO was observed in 46.7% of the patients but did not influence the clinical outcome. Conclusion: Both CDA with Prestige-LP Disc and ACDF showed good clinical outcomes at a minimum 6-year follow-up. Compared with ACDF, CDA preserved the motion and reduced the incidence of ASD.