{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T15:24:29Z","timestamp":1780413869014,"version":"3.54.1"},"reference-count":138,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Anterior cervical discectomy and fusion (ACDF) is a standard surgical approach for cervical spondylotic myelopathy (CSM) caused by disc herniations. Although cervical disc arthroplasty (CDA) has become, in the past decade, a viable alternative to ACDF in selected patients, the differences among patients with CSM treated with CDA and ACDF remain elusive. The effectiveness of motion preservation devices in CSM is also unclear.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Adult patients who underwent 1- or 2-level CDA or ACDF between 2007 and 2021 were retrospectively reviewed. Patients whose preoperative T2-weighted MRI demonstrated increased intramedullary signal intensity (IISI) were included and analyzed for the following: comparison of the length of IISI on pre- and postoperative MR images as well as range of motion (ROM) at the indexed levels between the CDA and ACDF groups. Measurement for clinical outcomes included the visual analog scale (VAS) of the arm and neck, the Neck Disability Index, and modified Japanese Orthopaedic Association scores. Perioperative clinical data were also compared between the two groups.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 122 patients were allocated to the CDA group and 108 to the ACDF group, with mean follow-ups of 46.6 and 39.0 months, respectively. Patients in the CDA group were younger than those in the ACDF group (47.64 \u00b1 12.40 vs 61.73 \u00b1 12.25 years, p < 0.001) (mean \u00b1 SD). The ACDF group had more 2-level surgery compared to the CDA group (p = 0.002). Both groups had significant regression of IISI on postoperative MRI compared to that of preoperative imaging (CDA: 1.23 \u00b1 0.84 to 0.28 \u00b1 0.39 cm; ACDF: 1.07 \u00b1 0.60 to 0.37 \u00b1 0.42 cm; both p < 0.001). The decrease in the length of IISI was similar between the two groups (p = 0.058). The postoperative ROM was well preserved in the CDA group (superior to ACDF, which yielded minimal ROM postoperatively). Both the CDA and ACDF groups demonstrated improvement in Neck Disability Index and modified Japanese Orthopaedic Association scores at 24 months postoperatively. The CDA group had significant improvements on VAS scores, whereas the improvement did not reach significance for the ACDF group at 24 months postoperatively.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Significant shortening of IISI on T2-weighted MRI was demonstrated after both CDA and ACDF. At 24 months postoperatively, all clinical outcomes demonstrated improvement after both strategies, except that the VAS score was not significantly improved for ACDF. Therefore, CDA is a safe and effective option for patients with MR-evident CSM.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2023.6.focus23291","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T06:56:30Z","timestamp":1693551390000},"page":"E3","source":"Crossref","is-referenced-by-count":5,"title":["Cervical disc arthroplasty for magnetic resonance\u2013evident cervical spondylotic myelopathy: comparison with anterior cervical discectomy and fusion"],"prefix":"10.3171","volume":"55","author":[{"given":"Tsai-Tzu","family":"Ko","sequence":"first","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Yangming Branch, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Lan","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Radiology, Taipei Veterans General Hospital, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsuan-Kan","family":"Chang","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Chang","family":"Chang","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hsuan","family":"Kuo","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Yin","family":"Yeh","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Hung","family":"Kuo","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Chu","family":"Ko","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Yu","family":"Fay","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Hsi","family":"Tu","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jau-Ching","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Medicine, National Yang Ming Chiao Tung University, Taipei;"},{"name":"Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei;"},{"name":"Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"J Neurosurg Spine","first-page":"104","article-title":"The natural history of cervical spondylotic myelopathy","volume":"11","author":"Matz PG","year":"2009","unstructured":"Matz PG, Anderson PA, Holly LT, The natural history of cervical spondylotic myelopathy. 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Int J Surg. 2019;68:48\u201355."},{"issue":"6","key":"b18","series-title":"Neurosurgery","first-page":"1231","article-title":"The effect of T1-slope in spinal parameters after cervical disc arthroplasty","volume":"87","author":"Kuo YH","year":"2020","unstructured":"Kuo YH, Kuo CH, Chang HK, The effect of T1-slope in spinal parameters after cervical disc arthroplasty. Neurosurgery. 2020;87(6):1231\u20131239."},{"issue":"1","key":"b19","series-title":"BMC Musculoskelet Disord","first-page":"115","article-title":"Radiological and clinical outcomes of cervical disc arthroplasty for the elderly: a comparison with young patients","volume":"20","author":"Wu JC","year":"2019","unstructured":"Wu JC, Chang HK, Huang WC, Radiological and clinical outcomes of cervical disc arthroplasty for the elderly: a comparison with young patients. 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