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Artificial disc rep...
Artificial disc replacement versus fusion in patients with cervical degenerative disc disease and radiculopathy : a randomized controlled trial with 5-year outcomes
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- MacDowall, Anna (author)
- Uppsala universitet,Ortopedi
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- Canto Moreira, Nuno, 1962- (author)
- Department of Clinical Neuroscience (CNS), K8, Karolinska Universitetssjukhuset Solna, Stockholm
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- Marques, Catarina, 1969- (author)
- Uppsala universitet,Ortopedi
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- Skeppholm, Martin, 1965- (author)
- Karolinska Inst, Med Management Ctr, Hlth Econ & Hlth Evaluat Res Grp, Dept Learning Informat Management & Eth LIME, Stockholm, Sweden;Sophiahemmets Sjukhus, Ctr Spine Surg Stockholm, Stockholm, Sweden
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- Lindhagen, Lars (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Robinson, Yohan, 1977- (author)
- Uppsala universitet,Ortopedi
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- Löfgren, Håkan (author)
- Länssjukhuset Ryhov, Jönköping
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- Michaëlsson, Karl, 1959- (author)
- Uppsala universitet,Ortopedi
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- Olerud, Claes (author)
- Uppsala universitet,Ortopedi
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(creator_code:org_t)
- 2019
- 2019
- English.
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In: Journal of Neurosurgery. - 1547-5654 .- 1547-5646. ; 30:3, s. 323-331
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.3...
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Abstract
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- OBJECTIVEThe method of artificial disc replacement (ADR) has been developed as an alternative treatment to fusion surgery after decompression for cervical degenerative disc disease (DDD) with radiculopathy. Preserving the motion of ADR devices aims to prevent immobilization side effects such as adjacent-segment pathology (ASP). However, long-term follow-up evaluations using MRI are needed to investigate if this intent is achieved.METHODSThe authors performed a randomized controlled trial with 153 patients (mean age 47 years) undergoing surgery for cervical radiculopathy. Eighty-three patients received an ADR and 70 patients underwent fusion surgery. Outcomes after 5 years were assessed using patient-reported outcome measures using the Neck Disability Index (NDI) score as the primary outcome; motion preservation and heterotopic ossification by radiography; ASP by MRI; and secondary surgical procedures.RESULTSScores on the NDI were approximately halved in both groups: the mean score after 5 years was 36 (95% confidence interval [CI] 31–41) in the ADR group and 32 (95% CI 27–38) in the fusion group (p = 0.48). There were no other significant differences between the groups in six other patient-related outcome measures. Fifty-four percent of the patients in the ADR group preserved motion at the operated cervical level and 25% of the ADRs were spontaneously fused. Seventeen ADR patients (21%) and 7 fusion patients (10%) underwent secondary surgery (p = 0.11), with 5 patients in each group due to clinical ASP.CONCLUSIONSIn patients with cervical DDD and radiculopathy decompression as well as ADR, surgery did not result in better clinical or radiological outcomes after 5 years compared with decompression and fusion surgery.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- artificial disc replacement
- treatment outcome
- Neck Disability Index
- cervical radiculopathy
- adjacent-segment pathology
- Orthopaedics
- Ortopedi
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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MacDowall, Anna
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Canto Moreira, N ...
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Marques, Catarin ...
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Skeppholm, Marti ...
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Lindhagen, Lars
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Robinson, Yohan, ...
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show more...
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Löfgren, Håkan
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Michaëlsson, Kar ...
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Olerud, Claes
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Orthopaedics
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Journal of Neuro ...
- By the university
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Uppsala University
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Karolinska Institutet