Authors: Kee D. Kim, MD, FAANS; Greg Hoffman, MD; Hyun Bae, MD; Michael Hisey, MD; Andy Redmond, MD; Pierce Nunley, MD; David Tahernia, MD; Robert Jackson, MD; Ali Araghi, DO (Sacramento, CA)
Short- and mid-term studies have shown the effectiveness of cervical disc arthroplasty (CDA) to treat cervical disc degeneration. The purpose of this study is to report the 10-year outcomes of a multicenter experience with cervical arthroplasty for 1- and 2-level pathology.
This was a prospective cohort study of patients treated with CDA at one- or two contiguous levels. Upon completion of the 7-year FDA study, follow-up continued at 10 years for consenting patients at nine high-enrolling centers. Outcomes included VAS neck and arm pain, neck disability index (NDI), neurologic status, patient satisfaction, secondary surgery and adverse events. Radiographic endpoints included segmental and global range of motion (ROM), sagittal alignment, adjacent level degeneration and heterotopic ossification.
Ten-year follow-up was obtained from 187 of 231 eligible patients (81%). The longest follow-up was 11.2 years. Ten years after CDA, patients continued to have significant improvement from baseline. Outcomes at 10 years were improved from 7 years for neck pain, arm pain and NDI. Neurologic deterioration at 10 years was 13.7% vs. 14.0% at 7 years (p=0.94). Both flexion-extension and lateral bending range of motion were not significantly different from 7-year values (p>0.05). Global ROM and sagittal alignment also were maintained from 7 to 10 years. At 10 years, 98.4% of patients were satisfied with their disc replacement surgery. The incidence of subsequent surgery after 10 years was 4.7% (12/257) at the index level and 3.5% (9/257) at an adjacent level.
At 10-years, both 1- and 2-level CDA maintained improvement of pain scores, NDI, neurologic deficit, ROM and sagittal alignment compared to baseline. Our results through 10 years demonstrate that CDA with Mobi-C continues to be a safe and effective surgical treatment for patients with 1- or 2-level cervical degenerative disc disease.